Crystalline forms of trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide sodium salt

ABSTRACT

The present invention relates to novel crystalline forms of sodium salt of trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide (e.g., NXL-104) thereof. The present invention relates to compositions comprising a crystalline form of sodium salt of trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide (e.g., NXL-104) alone or in combination with an antibacterial agent (e.g., ceftaroline fosamil). Processes for the preparation of the crystalline forms and methods of treating bacterial infections by administering the crystalline forms alone or in combination with an antibacterial agent (e.g., ceftaroline fosamil) are also described.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/454,141 filed on Aug. 7, 2014 which is a continuation of U.S. patentapplication Ser. No. 13/901,724, which is a continuation of U.S. patentapplication Ser. No. 12/900,567 filed on Oct. 8, 2010 which claimspriority under 35 U.S.C. §119, based on French Application No. 0904864filed on Oct. 9, 2009 and U.S. Provisional Application Ser. No.61/263,663 filed on Nov. 23, 2009, the disclosures of all of which arehereby incorporated by reference in their entirety.

FIELD OF THE INVENTION

The present invention relates to novel crystalline forms oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and compositions comprising the crystallineforms alone or in combination with an antibacterial agent (e.g.,ceftaroline fosamil). Processes for the preparation of the crystallineforms and methods of treating bacterial infections by administering thecrystalline forms alone or in combination with an antibacterial agent(e.g., ceftaroline fosamil) are also described.

BACKGROUND OF THE INVENTION

U.S. Pat. No. 7,112,592 discloses novel heterocyclic compounds and theirsalts, processes for making the compounds and methods of using thecompounds as antibacterial agents. One such compound is sodium salt oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide.Application WO 02/10172 describes the production of azabicycliccompounds and salts thereof with acids and bases, and in particular,trans-7-oxo-6-sulphoxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide andits pyridinium, tetrabutylammonium and sodium salts. Application WO03/063864 and U.S. Patent Publication No. 2005/0020572 describe the useof compounds includingtrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt, as β-lactamase inhibitors that can be administered alone orin, combination with β-lactamine antibacterial agents. These referencesare incorporated herein by reference, in their entirety.

Ceftaroline is a novel parenteral cephalosporin with a broad spectrum ofactivity against clinically important community-acquired andhospital-acquired Gram-negative and Gram-positive pathogens includingmethicillin-resistant Staphylococcus aureus and multidrug-resistantStreptococcus pneumoniae.

U.S. Pat. No. 6,417,175 discloses compounds having excellentantibacterial activities for a broad range of Gram-positive andGram-negative bacteria. These compounds are represented by the generalformula:

wherein R¹-R⁴, Q, X, Y and n are as defined therein.

U.S. Pat. No. 6,417,175 discloses methods for preparing the compounds,and generically discloses formulations of the compounds, such as aqueousand saline solutions for injection. One such compound is7β-[2(Z)-ethoxyimino-2-(5-phosphonoamino-1,2,4-thiadiazole-3-yl)acetamido]-3-[4-(1-methyl-4-pyridinio)-2-thiazolythio]-3-cephem-4-carboxylate.

U.S. Pat. No. 6,906,055 discloses a chemical genus which includescompounds of formula:

Ceftaroline fosamil is a sterile, synthetic, parenteral prodrugcephalosporin antibiotic. The N-phosphonoamino water-soluble prodrug israpidly converted into the bioactive ceftaroline, which has beendemonstrated to exhibit antibacterial activity. Ceftaroline fosamil isknown as(6R,7R)-7-{(2Z)-2-(ethoxyimino)-2-[5-(phosphonoamino)-1,2,4-thiadiazol-3-yl]acetamido}-3-{[4-(1-methylpyridin-1-ium-4-yl)-1,3-thiazol-2-yl]sulfanyl}-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-ene-2-carboxylate.Ceftaroline fosamil may be an acetic acid hydrous form.

U.S. Pat. No. 7,419,973 discloses compositions comprising ceftarolinefosamil and a pH adjuster, such as, L-arginine.

U.S. Pat. Nos. 6,417,175 and 6,906,055 and 7,419,973 are incorporatedherein by reference, in their entirety.

The present invention relates to the solid state physical properties oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104). These properties may be influenced bycontrolling the conditions under whichtrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) is obtained in solid form.

Solid state physical properties include, for example, the flowability ofthe milled solid, rate of dissolution and stability. The physicalcharacteristics are influenced by the conformation and orientation ofmolecules in the unit cell, which defines a particular crystalline formof a substance. A crystalline form may give rise to thermal behaviordifferent from that of the amorphous material or another crystallineform. Thermal behavior is measured in the laboratory using techniquessuch as capillary melting point, thermogravimetric analysis (TGA) anddifferential scanning calorimetry (DSC). These techniques may be used todistinguish between different crystalline forms. A particularcrystalline form may show distinct spectroscopic properties that can bedetected using powder X-ray diffractometry (XRPD), nuclear magneticresonance (NMR) spectrometry, Raman spectroscopy and infrared (IR)spectrometry.

In deciding which crystalline form is preferable, the numerousproperties of the crystalline forms must be compared and the preferredcrystalline form chosen based on the many physical property variables. Aparticular crystalline form may be preferable in certain circumstancesin which certain aspects, such as ease of preparation, stability, etc.,are deemed to be critical. In other situations, a different crystallineform may be preferred for greater solubility and/or superiorpharmacokinetics.

The discovery of new crystalline forms of a pharmaceutically usefulcompound provides a new opportunity to improve the performancecharacteristics of a pharmaceutical product. New crystalline forms oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt have now been discovered.

There is an existing and continual need in the art for new and improvedcompositions and methods for treating bacterial infections byadministering antibacterial agents. Surprisingly and unexpectedly,compositions comprising a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and ceftaroline fosamil have been found to stable. Suchformulations may be used for the treatment of bacterial infections, suchas, complicated skin and structure infection and community acquiredpneumonia.

SUMMARY OF THE INVENTION

The present invention relates to novel crystalline forms oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104).

The present invention provides compositions comprising a crystallineform oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) alone or in combination with anantibacterial agent (e.g., ceftaroline fosamil). Methods of treatingbacterial infections by administering the crystalline forms alone or incombination with an antibacterial agent (e.g., ceftaroline fosamil) arealso described.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1 shows the powder X-Ray diffraction pattern of amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104).

FIG. 2 shows the powder X-Ray diffraction pattern of Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104).

FIG. 3 shows the powder X-Ray diffraction pattern of Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104).

FIG. 4 shows the powder X-Ray diffraction pattern of Form III oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104).

FIG. 5 shows the powder X-Ray diffraction pattern of Form IV oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104).

FIG. 6 shows the powder X-Ray diffraction pattern of Form V oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104).

DETAILED DESCRIPTION OF THE INVENTION

The present invention provides novel crystalline forms oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104). NXL-104 may also be referred to asmonosodium salt of(1R,2S,5R)-7-oxo-6-sulphoxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.

The crystalline forms may be hydrated (e.g., a monohydrate or adihydrate) or anhydrous.

The present invention also provides compositions comprising thecrystalline forms alone or in combination with an antibacterial agent(e.g., ceftaroline fosamil), processes for making the crystalline formsand methods of treating bacterial infections by administering thecrystalline forms alone or in combination with an antibacterial agent(e.g., ceftaroline fosamil).

Form I

In one aspect, the present invention provides a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt called Form I.

In specific examples, the present invention provides a crystalline formof sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidecalled Form I.

The sodium salt oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide,in particular,(1R,2S,5R)-7-oxo-6-sulphoxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,is a beta-lactamase inhibitor, which reacts with a protein, forming acovalent bond. This reactive inhibitor, a consequence of the internalstrain of the N-oxosulphoxyurea ring, is intrinsically sensitive tomoisture and to heat, just like the β-lactams, although it is not one.The main manner of degradation of the sodium salt of(1R,2S,5R)-7-oxo-6-sulphoxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis by hydrolysis of the N-oxosulphoxyurea ring. To minimize degradation,it is advantageous to isolate this molecule at room temperature or atlow temperature and minimize the duration of exposure in aqueoussolution. These conditions are fulfilled during crystallization orlyophilisation but are difficult to fulfil during concentration of anaqueous solution to dryness, as described in Application WO 02/10172. Inpractice, the aqueous solution containing the sodium salt of(1R,2S,5R)-7-oxo-6-sulphoxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidecan only be concentrated by lyophilisation, in order to obtain theproduct in the amorphous form.

In exemplary embodiments, the Form I is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak, such as, at about13.0+/−0.5 degrees 2θ. In other embodiments, the Form I is characterizedby an X-Ray powder diffraction pattern comprising a characteristic peakat about 16.5+/−0.5 degrees 2θ. In still other embodiments, the Form Iis characterized by an X-Ray powder diffraction pattern comprising acharacteristic peak at about 17.5+/−0.5 degrees 2θ.

In exemplary embodiments, the Form I is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 13.0;about 16.5, about 17.5+/−0.5 degrees 2θ or a combination thereof. Infurther embodiments, the Form I is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 17.3;about 22.3+/−0.5 degrees 2θ or a combination thereof. In otherembodiments, the Form I is further characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 19.2 orabout 19.5+/−0.5 degrees 2θ or a combination thereof. In furtherembodiments, the Form I is characterized by an X-Ray powder diffractionpattern comprising a characteristic peak at about 19.9; about 22.0;about 25.2; about 28.2+/−0.5 degrees 2θ or a combination thereof.

In specific embodiments, the Form I is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 13.0;about 16.5; about 17.3; about 17.5; about 19.2; about 19.5; about 19.9;about 22.0; about 22.3; about 25.2; or about 28.2+/−0.5 degrees 2θ or acombination thereof. In further embodiments, the Form I is characterizedby an X-Ray powder diffraction pattern comprising a characteristic peakat about 23.2; about 30.2; about 30.9; about 36.1+/−0.5 degrees 2θ or acombination thereof. In exemplary embodiments, the Form I ischaracterized by an X-Ray powder diffraction pattern comprising one ormore characteristic peaks at 2θ (±0.1°) 12.97, 16.45, 17.24, 17.45,22.29.

In exemplary embodiments, the Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) is characterized by an X-Ray powderdiffraction pattern comprising characteristic peaks at about 13.0; about16.5; about 17.3; about 17.5; about 19.2; about 19.5; about 19.9; about22.0; about 22.3; about 23.2; about 25.2; about 28.2; about 30.2; about30.9 and about 36.1+/−0.5 degrees 2θ.

In some embodiments, the Form I is characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value, such as, at about6.8+/−2 nm. In other embodiments, the Form I is characterized by anX-Ray powder diffraction pattern comprising a d-spacing value at about5.1+/−2 nm. In still other embodiments, the Form I is characterized byan X-Ray powder diffraction pattern comprising a d-spacing value atabout 5.4+/−2 nm.

In exemplary embodiments, the Form I is characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value at about 5.1; about5.4; about 6.8+/−2 nm or a combination thereof. In further embodiments,the Form I is characterized by an X-Ray powder diffraction patterncomprising a d-spacing value at about 4.0+/−2 nm. In other embodiments,the Form I characterized by an X-Ray powder diffraction patterncomprising a d-spacing value at about 4.6+/−2 nm. In furtherembodiments, the Form I is characterized by an X-Ray powder diffractionpattern comprising a d-spacing value at about 3.2; about 3.5; about 4.0;about 4.5+/−2 nm or a combination thereof.

In certain embodiments, the Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) is characterized by an X-Ray powderdiffraction pattern comprising d-spacing values at about 2.5; about 2.9;about 3.0; about 3.2; about 3.5; about 3.8; about 4.0; about 4.5; about4.6; about 5.1; about 5.4 or about 6.8+/−2 nm or a combination thereof.

In exemplary embodiments, the Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) is characterized by an X-Ray powderdiffraction pattern comprising d-spacing values at about 2.5; about 2.9;about 3.0; about 3.2; about 3.5; about 3.8; about 4.0; about 4.5; about4.6; about 5.1; about 5.4; and about 6.8+/−2 nm.

Form II

In another aspect, the present invention provides a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) called Form II.

For example, the present invention provides a crystalline form of sodiumsalt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidecalled Form II.

In some embodiments, the Form II is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 8.5; about15.4; about 16.4; about 17.1; about 23.5 or about 24.3+/−0.5 degrees 2θor a combination thereof.

In exemplary embodiments, the Form II is characterized by an X-Raypowder diffraction pattern comprising a characteristic peak at about17.1+/−0.5 degrees 2θ. In other embodiments, the Form II ischaracterized by an X-Ray powder diffraction pattern comprising acharacteristic peak at about 16.4+/−0.5 degrees 2θ. In still otherembodiments, the Form II is characterized by an X-Ray powder diffractionpattern comprising a characteristic peak at about 8.5+/−0.5 degrees 2θ.

In further embodiments, the Form II characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 15.4;about 23.5+/−0.5 degrees 2θ or a combination thereof. In otherembodiments, the Form II is further characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 24.3+/−0.5degrees 2θ. In exemplary embodiments, the Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt is characterized by an X-Ray powder diffraction patterncomprising characteristic peaks at about 8.5; about 15.4; about 16.4;about 17.1; about 23.5 and about 24.3+/−0.5 degrees 2θ. In furtherspecific embodiments, the Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt is characterized by one or more peaks at 2θ (±0.1°) 8.48,15.34, 16.38, 17.04, 24.28.

In specific embodiments, the Form II is characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value at about 3.7; about3.8; about 5.2; about 5.4; about 5.8 or about 10.4+/−2 nm or acombination thereof.

In some embodiments, the Form II is characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value, such as, at about5.2+/−2 nm.

In other embodiments, the Form II is characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value at about 5.4+/−2 nm. Instill other embodiments, the Form II is characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value at about 10.4+/−2 nm.In further embodiments, the Form II characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value at about 3.8 or about5.8+/−2 nm or a combination thereof.

In exemplary embodiments, the Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) is characterized by an X-Ray powderdiffraction pattern comprising d-spacing values at about 3.7; about 3.8;about 5.2; about 5.4; about 5.8 and about 10.4+/−2 nm.

Form III

In another aspect, the present invention, relates to a crystalline formof trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) called Form III.

For example, the present invention provides a crystalline form of sodiumsalt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidecalled Form III.

In exemplary embodiments, the Form III is characterized by an X-Raypowder diffraction pattern comprising characteristic peaks at about 9.8;about 13.6; about 15.0; about 15.8; about 19.5; about 19.7; about 22.5;about 22.8; about 23.5; about 24.3; about 24.6; about 27.6; about 27.9;about 29.8 or about 31.7+/−0.5 degrees 2θ or a combination thereof.

In exemplary embodiments, the Form III is characterized by an X-Raypowder diffraction pattern comprising a characteristic peak at about9.8+/−0.5 degrees 2θ. In other embodiments, the Form III ischaracterized by an X-Ray powder diffraction pattern comprising acharacteristic peak at about 19.5+/−0.5 degrees 2θ. In still otherembodiments, the Form III is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 15.0;about 15.8 or about 22.5+/−0.5 degrees 2θ or a combination thereof.

In some embodiments, the Form III is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 13.6;about 19.7; about 23.5; about 24.6 or about 29.8+/−0.5 degrees 2θ or acombination thereof. In further embodiments, the Form III ischaracterized by an X-Ray powder diffraction pattern comprising acharacteristic peak at about 22.8; about 24.3; about 27.6; about 27.9 orabout 31.7+/−0.5 degrees 2θ or a combination thereof.

In exemplary embodiments, the Form III is characterized by an X-Raypowder diffraction pattern comprising characteristic peaks at about 9.8;about 13.6; about 15.0; about 15.8; about 19.5; about 19.7; about 22.5;about 22.8; about 23.5; about 24.3; about 24.6; about 27.6; about 27.9;about 29.8; about 31.7 and +/−0.5 degrees 2θ. In exemplary embodiments,the Form III is characterized by an X-Ray powder diffraction patterncomprising one or more characteristic peaks at 2θ (±0.1°) 13.65, 15.01,15.38, 15.72, 19.42.

In some embodiments, the Form III is characterized by an X-Ray powderdiffraction pattern comprising d-spacing values at about 2.8; about 3.0;about 3.2; about 3.6; about 3.7; about 3.8; about 3.9; about 4.0; about4.5; about 4.6; about 5.6; about 5.9; about 6.5 or about 9.0+/−2 nm or acombination thereof.

In exemplary embodiments, the Form III is characterized by an X-Raypowder diffraction pattern comprising a d-spacing value, such as, atabout 9.0+/−2 nm. In other embodiments, the Form III is characterized byan X-Ray powder diffraction pattern comprising a d-spacing value atabout 4.6+/−2 nm. In still other embodiments, the Form III ischaracterized by an X-Ray powder diffraction pattern comprising ad-spacing value at about 4.0; about 4.5; about 5.6; about 5.9 or about6.5+/−2 nm or a combination thereof.

In further embodiments, the Form III is characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value at about 2.8; about3.0; about 3.2; about 3.6; about 3.7; about 3.8 or about 3.9+/−2 nm or acombination thereof.

In exemplary embodiments, the Form III is characterized by an X-Raypowder diffraction pattern comprising d-spacing values at about 2.8;about 3.0; about 3.2; about 3.6; about 3.7; about 3.8; about 3.9; about4.0; about 4.5; about 4.6; about 5.6; about 5.9; about 6.5 and about9.0+/−2 nm.

Form IV

In another aspect, the present invention provides the present inventionprovides a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) called Form IV.

For example, the present invention provides a crystalline form of sodiumsalt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidecalled Form IV.

In some embodiments, the Form IV is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak, such as, at about8.7; about 11.3; about 12.5; about 16.3; about 17.5; about 17.8; about18.6; about 21.0; about 22.3; about 26.2; about 26.6; about 26.9; about27.6; about 28.7; about 29.8; about 30.4; about 31.2; about 32.9; about33.4; about 34.4; about 37.1; about 37.3; about 37.6 or about 38.5+/−0.5degrees 2θ or a combination thereof.

In exemplary embodiments, the Form IV is characterized by an X-Raypowder diffraction pattern comprising a characteristic peak at about18.6+/−0.5 degrees 2θ. In other embodiments, the Form IV ischaracterized by an X-Ray powder diffraction pattern comprising acharacteristic peak at about 17.5+/−0.5 degrees 2θ. In still otherembodiments, the Form IV is characterized by an X-Ray powder diffractionpattern comprising a characteristic peak at about 17.8+/−0.5 degrees 2θ.In certain embodiments, the Form IV is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 16.3+/−0.5degrees 2θ.

In some embodiments, the Form IV is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak, such as, at about8.7 or about 22.3+/−0.5 degrees 2θ.

The Form IV may be further characterized by an X-Ray powder diffractionpattern comprising a characteristic peak at about 12.5; about 21.0;about 26.6 or about 26.9; +/−0.5 degrees 2θ or a combination thereof. Inother embodiments, the Form IV may be further characterized by an X-Raypowder diffraction pattern comprising a characteristic peak at about11.3; about 26.2; about 27.6; about 28.7; about 29.8; about 30.4; about31.2; about 32.9; about 33.4; about 34.4; about 37.1; about 37.3; about37.6 or about 38.5+/−0.5 degrees 2θ or a combination thereof.

In exemplary embodiments, the Form IV is characterized by an X-Raypowder diffraction pattern comprising a characteristic peak, such as, atabout 8.7; about 11.3; about 12.5; about 16.3; about 17.5; about 17.8;about 18.6; about 21.0; about 22.3; about 26.2; about 26.6; about 26.9;about 27.6; about 28.7; about 29.8; about 30.4; about 31.2; about 32.9;about 33.4; about 34.4; about 37.1; about 37.3; about 37.6 and about38.5+/−0.5 degrees 2θ or a combination thereof.

In specific embodiments, the Form IV is characterized by an X-Ray powderdiffraction pattern comprising d-spacing values at about 2.3; about 2.4;about 2.6; about 2.7; about 2.9; about 3.0; about 3.1; about 3.2; about3.3; about 3.4; about 4.0; about 4.2; about 4.8; about 5.0; about 5.1;about 5.4; about 7.1; about 7.8 or about 10.1+/−2 nm or a combinationthereof.

In exemplary embodiments, the Form IV is characterized by an X-Raypowder diffraction pattern comprising a d-spacing value, such as, atabout 4.8+/−2 nm. In other embodiments, the Form IV is characterized byan X-Ray powder diffraction pattern comprising a d-spacing value atabout 5.1+/−2 nm. In still other embodiments, the Form IV ischaracterized by an X-Ray powder diffraction pattern comprising ad-spacing value at about 4.0; about 5.0; about 5.4 or about 10.1+/−2 nmor a combination thereof.

In some embodiments, the Form IV is further characterized by an X-Raypowder diffraction pattern comprising a d-spacing value at about 3.3;about 4.2 or about 7.1+/−2 nm or a combination thereof. In otherembodiments, the Form IV is further characterized by an X-Ray powderdiffraction pattern comprising a d-spacing value at about 2.3; about2.4; about 2.6; about 2.7; about 2.9; about 3.0; about 3.1; about 3.2;about 3.4 or about 7.8+/−2 nm or a combination thereof.

For example, the Form IV is characterized by an X-Ray powder diffractionpattern comprising d-spacing values at about 2.3; about 2.4; about 2.6;about 2.7; about 2.9; about 3.0; about 3.1; about 3.2; about 3.3; about3.4; about 4.0; about 4.2; about 4.8; about 5.0; about 5.1; about 5.4;about 7.1; about 7.8 and about 10.1+/−2 nm.

Form V

In another aspect, the present invention provides a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) called Form V.

For example, the present invention provides a crystalline form of sodiumsalt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidecalled Form V.

In exemplary embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak, such as, at about6.5; about 8.5; about 13.4; about 14.4; about 15.4; about 15.5; about16.4; about 17.1; about 18.0; about 19.3; about 19.5; about 21.0; about22.9; about 24.3; about 27.3 or about 31.9+/−0.5 degrees 2θ or acombination thereof.

In some embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 6.5+/−0.5degrees 2θ. In other embodiments, the Form V is characterized by anX-Ray powder diffraction pattern comprising a characteristic peak atabout 18.0+/−0.5 degrees 2θ. In still other embodiments, the Form V ischaracterized by an X-Ray powder diffraction pattern comprising acharacteristic peak at about 19.3+/−0.5 degrees 2θ. The Form V may befurther characterized by an X-Ray powder diffraction pattern comprisinga characteristic peak at about 14.4; about 15.5; about 16.4; about 17.1or about 19.5+/−0.5 degrees 2θ or a combination thereof. In still otherembodiments, the Form V may be further characterized by an X-Ray powderdiffraction pattern comprising a characteristic peak at about 8.5; about13.4; about 15.4; about 21.0; about 22.9; about 24.3; about 27.3 orabout 31.9+/−0.5 degrees 2θ or a combination thereof.

In exemplary embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising characteristic peaks at about 6.5; about8.5; about 13.4; about 14.4; about 15.4; about 15.5; about 16.4; about17.1; about 18.0; about 19.3; about 19.5; about 21.0; about 22.9; about24.3; about 27.3 and about 31.9+/−0.5 degrees 2θ.

In some embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a d spacing value at about 2.8; about3.3; about 3.7; about 3.9; about 4.2; about 4.5; about 4.6; about 4.9;about 5.2; about 5.4; about 5.7; about 5.8; about 6.1; about 6.6; about10.4 or about 13.6+/−2 nm or a combination thereof.

In some embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a d spacing value at about 13.6+/−2 nm.In other embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a d spacing value at about 4.6+/−2 nm. Instill other embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a d spacing value at about 4.9+/−2 nm. Incertain embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a d spacing value at about 6.1+/−2 nm.The X-Ray powder diffraction pattern may further comprise a d spacingvalue at about 2.8; about 3.3; about 3.7; about 3.9; about 4.2; about4.5; about 5.2; about 5.4; about 5.7; about 5.8; about 6.6 or about10.4+/−2 nm or a combination thereof.

In exemplary embodiments, the Form V is characterized by an X-Ray powderdiffraction pattern comprising a d spacing value at about 2.8; about3.3; about 3.7; about 3.9; about 4.2; about 4.5; about 4.6; about 4.9;about 5.2; about 5.4; about 5.7; about 5.8; about 6.1; about 6.6; about10.4 and about 13.6+/−2 nm.

In exemplary embodiments, the Form II is a monohydrate containing 5.90%water (weight/weight) and the Form III is a dihydrate. By couplingthermogravimetric analysis (TGA) with differential thermal analysis(SDTA) at 10° C./min, the Form II displays a weight loss of 5.7% atapproximately 110° C., corresponding to the dehydration of the salt,followed by a decomposition exotherm with weight loss between 220 and240° C. By the same technique, the Form III displays a first weight lossof 5% at approximately 60° C. and then a second weight loss of 5% atapproximately 100° C. before decomposition between 220 and 240° C. Thisloss of water in 2 stages corresponds to a dihydrated form with twonon-equivalent molecules of water in the crystal lattice.

In exemplary embodiments, the Forms I, IV or V are anhydrous. A maximumamount of water from 0 to 0.6% is detected by Karl Fischer analysis in aproduct of Form I prepared as described later in the application. Thepolymorphic forms I and IV display an exothermic decomposition peakbetween 220 and 240° C. measured by DSC (Differential Scanningcalorimetry).

In some embodiments, the experimental powder diffraction patterns areobtained by diffraction of X-rays on powder in a Rigaku Miniflex X-raydiffractometer with the Kα radiation of copper (λ=1.541 Å). The samples,without grinding, are put on a glass plate and are analyzed at ambienttemperature and humidity. Data are collected at 0.05° interval,2°/minute from 3°-40° 2θ. In some examples, the peaks with a relativeintensity of more than about 10% are considered as characteristic peaks.

In other embodiments, the experimental powder diffraction patterns areobtained by diffraction of X-rays on powder in an X'pert Pro Philipsinstrument with the Kα, radiation of copper (λ=1.5406 Å). The samples,without grinding, are put on a glass plate and are analyzed at ambienttemperature and humidity with an angle 2θ from 5 to 50°. In someexamples, the characteristic peaks of each form are determined usingfive lines that are generally the most intense. The mean value of eachpeak and its standard deviation are calculated from the experimentalvalues of representative samples of each form.

In some embodiments, the crystal structures of the monocrystals of thedihydrate forms are obtained at 296K on a Rigaku Rapid R axisdiffractometer equipped with a rotating copper anode (1=1.5406 Å). Thecrystals structures of monocrystal of the monohydrate form are obtainedat 233K on a Bruker Nonius diffractometer with the Kα radiation ofmolybdenum (1=0.7093 Å). Powder diffraction patterns are normallymeasured using copper Ka radiation. For comparison with the experimentalpowder patterns, the theoretical powder diffraction patterns for thehydrate forms are calculated from the corresponding crystal structuredata using the appropriate 1 value for copper Ka radiation (1.5406 Å).

One skilled in the art will understand that the relative intensities andpositions of the peaks obtained by X-Ray powder diffraction may varydepending upon factors such as, the sample preparation technique, thesample mounting procedure and the particular instrument employed. Forexample, in additional embodiments, the listed X-Ray powder diffractionpattern peaks for the crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) may be about +/−0.2 degrees 2θ.

It is known that an X-ray powder diffraction pattern may be obtainedwhich has one or more measurement errors depending on measurementconditions (such as equipment or machine used). Intensities in an X-raypowder diffraction pattern may fluctuate depending on measurementconditions. Therefore, it should be understood that the crystallineforms of the present invention are not limited to the crystals thatprovide X-ray powder diffraction patterns identical to the X-ray powderdiffraction patterns described in this application, and any crystalsproviding X-ray powder diffraction patterns substantially the same asthose described in the application fall within the scope of the presentinvention. For example, relative intensity of peaks can be affected bygrains above 30 microns in size and non-unitary aspect ratios, which mayaffect analysis of samples. A person skilled in the art will recognizethat the position of reflections can be affected by the precise heightat which the sample sits in the diffractometer and the zero calibrationof the diffractometer. The surface planarity of the sample may also havea small effect. Therefore, the diffraction pattern data described hereinare not to be taken as absolute values. (Jenkins, R & Snyder, R. L.‘Introduction to X-Ray Powder Diffractometry’ John Wiley & Sons 1996;Bunn, C. W. (1948), Chemical Crystallography, Clarendon Press, London;Klug, H. P. & Alexander, L. E. (1974), X-Ray Diffraction Procedures).

Generally, a measurement error of a diffraction angle in an X-ray powderdiffractogram is about 5% or less, in particular plus or minus 0.5°2-theta, and such degree of a measurement error should be taken intoaccount when considering the X-ray powder diffraction patterns describedin this application. Furthermore, it should be understood thatintensities may fluctuate depending on experimental conditions andsample preparation (preferred orientation).

The standard deviation for d-spacing is calculated based on an angle of5° 2-theta. In some embodiments, the standard deviation for d-spacingmay be between +/−0.1 nm and +/−2 nm. For example, the d-spacing valuesfor the crystalline forms described in the application may vary by+/−0.2 nm, +/−0.3 nm, +/−0.5 nm, +/−1 nm, +/−1.5 nm or about +/−2 nm.

In one aspect, substantially pure crystalline forms of the presentinvention are provided. For example, the present invention includesForms I-V oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) as described in this application that areabout ≧95% pure. For example, the forms may be about ≧95%, ≧96%, ≧97%,≧98% or ≧99% pure.

In exemplary embodiments, the present invention provides Forms I-V ofsodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideas described in this application that are ≧95% pure. For example, theforms may be ≧95%, ≧96%, ≧97%, ≧98% or ≧99% pure.

In some embodiments, the Form I of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis isolated in a substantially pure form. In other embodiments, the FormII of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis isolated in a substantially pure form. In still other embodiments,the Form III of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis isolated in a substantially pure form. In other examples, the Form IVor Form V of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis isolated in a substantially pure form. The Forms described herein mayhave purity of more than about 90%, about 91%, about 92%, about 93%,about 94%, about 95%, about 96%, about 97%, about 98%, or about 99% byweight. In specific embodiments, the forms may have a purity of morethan about 95% by weight. For example, the forms may be ≧95%, ≧96%,≧97%, ≧98% or ≧99% pure.

Processes

In another aspect, the present invention provides processes forpreparing the crystalline forms oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) described in this application.

For example, the present invention relates to a method for thepreparation of the sodium salt of the(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideenantiomer shown below:

In exemplary embodiments, tetrabutylammonium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis treated in a (1-6 C) alkanol containing between 0 and 50% water, witha sodium salt that is soluble in the reaction mixture, and then thecrystals obtained are isolated. The sodium salt used may be an acetate,a butyrate, a hexanoate, an ethyl-hexanoate or a dodecylsulphate. Inspecific embodiments, the salt may be 2-ethyl-hexanoate. The process ofthe reaction is an equilibrium that is displaced by the crystallizationof the expected sodium salt, which can be applied advantageously on anindustrial scale, making the method particularly useful. Either thealcoholic solution of sodium 2-ethylhexanoate is added to the alcoholicsolution of the tetrabutylammonium salt, or vice versa. The (1-6 C)alkanol may be ethanol, propanol or linear or branched butanol. Inspecific embodiments, the alkanol may be ethanol. The operation may becarried out in the presence of 0 to 10% water, at a temperature between15 and 40° C.

The invention in particular relates to a method as defined above, forthe preparation of the sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,in an anhydrous form called Form I as described herein. In exemplaryembodiments, a solution of sodium 2-ethylhexanoate in pure ethanol isadded to a solution of the tetrabutylammonium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidein an ethanol/water mixture in such a way that the final proportion ofwater is from 0 to 5 wt. % of the solvent, operating at a temperaturefrom 10 to 40° C., in the presence of seed crystals of Form I or Form IIas described herein. The parameters, such as the proportion of water inthe reaction mixture, the duration of addition, the temperature and theconcentration are interdependent on the crystalline form. In order toobtain pure Form I, it is preferable to operate in the presence of seedcrystals of Form I and of a final proportion of water less than 2%,introducing the solution of sodium 2-ethylhexanoate over a period of 1to 7 hours and operating at a temperature from 10 to 40° C., and morepreferably, 30 to 35° C. In other embodiments, an ethanolic solution ofthe tetrabutylammonium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis added to an ethanol/water mixture of sodium 2-ethylhexanoate,moreover operating under the same conditions of solvent and temperaturesas those described above.

The invention also relates to a method as defined above, for thepreparation of the sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,in a monohydrate Form called Form II, as described herein. In exemplaryembodiments, a solution of sodium 2-ethylhexanoate in pure ethanol isadded to a solution of the tetrabutylammonium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidein an ethanol/water mixture in such a way that the final proportion ofwater is from 3 to 10 wt. % of the solvent, operating at a temperaturefrom 10 to 40° C. Crystallization is carried out in the absence of seedcrystals or by adding seed crystals of Form II. The parameters, such asthe proportion of water in the reaction mixture, the duration ofaddition, the temperature and the concentration act interdependently onthe crystalline form. In order to obtain the pure Form II, it ispreferable to operate at a temperature from 20 to 35° C. and morepreferably, at room temperature, in the presence of seed crystals of theForm II, a final proportion of water greater than 5 wt. % of thesolvent, and introducing the solution of sodium 2-ethylhexanoate over aperiod of 30 minutes to 2 hours.

In other embodiments, an ethanolic solution of the tetrabutylammoniumsalt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis added to an ethanol/water mixture of sodium 2-ethylhexanoate,operating under the same conditions of solvent and temperatures as thosedescribed above.

The invention also relates to a method as defined above, for thepreparation of the sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,in an anhydrous polymorphic called Form IV, as described herein. Inexemplary embodiments, an ethanolic solution of sodium 2-ethylhexanoateis added to an ethanolic solution of the tetrabutylammonium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,operating at room temperature. Crystallization is carried out in theabsence of seed crystals or by adding seed crystals of the polymorphicForm IV or optionally of the Form II. The parameters such as theproportion of water in the reaction mixture, the duration of addition,the temperature and the concentration act interdependently on thecrystalline form. In order to obtain pure Form IV, it is preferable tooperate in the absence of seed crystals, introducing the solution ofsodium 2-ethylhexanoate over a period of 30 minutes or less, andoperating at room temperature.

In other embodiments, an ethanolic solution of the tetrabutylammoniumsalt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideis added to an ethanolic solution of sodium 2-ethylhexanoate, operatingunder the same conditions of solvent and temperature as those describedabove.

The invention also relates to processes for making a dihydrate form ofthe sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidecalled Form III. In exemplary embodiments, crystals of Form II aresuspended in water, and the suspension is then left to evaporate slowlyin a humid atmosphere. Crystals can also been obtained by trituration ofcrystals of Form II in water or in an alkanol-water mixture, or byconversion, in a humid atmosphere, of the anhydrous Form I and Form IVto the monohydrated Form II and then to the dihydrated Form III. ThisForm III is particularly stable at higher humidities.

In exemplary embodiments, the methods comprise warming a filteredsolution of the tetrabutylammonium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide inethanol and mixing with a filtered solution of sodium 2-ethylhexanoatein ethanol, cooling the mixture, isolating the crystals by filtrationand drying the crystals under vacuum. For example, Form I may beprepared by this method.

In another example, 3.798 g of sodium 2-ethyl hexanoate (1.2equivalent), 100 ml ethanol and 5 ml distilled ionized water are stirreduntil full dissolution at room temperature. 10 g sulfaturamide dissolvedin 90 ml ethanol is added in 45 minutes and the addition funnel isrinsed with 5 ml ethanol. The suspension is stirred for 18 h at roomtemperature and cooled to 5° C. The suspension is stirred for 1-2 h at5° C. and filtered by gravity. The solid is washed with 2.5% aqueousethanol (3×30 ml) and dried at 20 mbar at 20° C. for 2-18 h untilconstant weight.

In other embodiments, the methods comprise mixing Form I seed crystalswith a filtered and warmed solution of tetrabutylammonium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide inethanol in a reactor and adding a filtered solution of sodium2-ethylhexanoate in ethanol, stirring the mixture, cooling the mixture,isolating the crystals by filtration, washing with ethanol and dryingthe crystals under vacuum.

In still other embodiments, the methods comprise mixing a warmed andfiltered solution of tetrabutylammonium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide inisobutanol with a filtered solution of sodium 2-ethylhexanoate inisobutanol, cooling the mixture, isolating the crystals by filtration;washing with an ice-cold mixture of isobutanol and water and drying thecrystals under vacuum.

In exemplary embodiments, the methods comprise mixing a solution ofsulfaturamide (SU) in ethanol with a solution of sodium 2-ethylhexanoate(SEH) in ethanol. The crystalline form may be obtained under anhydrousconditions using anhydrous SU and SEH. For example, Form IV may beprepared by this method.

In further embodiments, the Form I crystals may be vortexed in a saltsolution, e.g., sodium chloride, to provide Form III.

In some embodiments, seed crystals of Form I may be obtained bydissolving the amorphous sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidein 33 volumes of methanol, adding 10 volumes of ethanol at 60° C.,concentration of the solution to about 10 volumes at room temperatureand then distillation of the methanol to constant volume, still at roomtemperature, with ethanol (25 volumes are added). The Form I thusobtained is filtered and then dried.

In some embodiments, seed crystals of Form II may be obtained by adding,over forty-five minutes, 19 volumes of ethanol to a solution of theamorphous sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamidein one volume of water, cooling to 5° C. in one hour and then holding atthis temperature, filtration and finally drying.

In some embodiments, sulphaturamide or tetrabutylammonium salt of(1R,2S,5R)-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxamidemay be prepared by chiral resolution of its racemic precursortrans-7-oxo-6-(phenylmethoxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,the preparation of which is described in Example 33a Stage A inApplication WO 02/10172. In exemplary embodiments, injection of 20 μl ofa sample of 0.4 mg/mL oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,eluted on a Chiralpak ADH column (5 μm, 25 cm×4.6 mm) withheptane-ethanol-diethylamine mobile phase 650/350/0.05 vol at 1 mL/minmakes it possible to separate the (1R,2S,5R) and (1S,2R,5S) enantiomerswith retention times of 17.4 minutes and 10.8 minutes respectively. Thesulphaturamide is then obtained by conversion according to theconditions described in Example 33a Stage B then Stage C and finally inExample 33b of Application WO 02/10172.

In other embodiments, the sulphaturamide can be prepared from themixture of the oxalate salt of(2S)-5-benzyloxyamino-piperidine-2-carboxylic acid, benzyl ester(mixture (2S,5R)/(2S,5S)˜50/50) described in application FR2921060.

For example, the preparation may proceed in the following stages:

In stage A, dibenzoxurea or(2S)-7-oxo-6-(2-phenylmethoxy)-1,6-diaza-bicyclo[3.2.1]octane 2-benzyl2-carboxylate is prepared. A 10% saturated aqueous solution of sodiumbicarbonate (16 L) is added to a suspension of the oxalate salt of(2S)-5-benzyloxyamino-piperidine-2-carboxylic acid, benzyl ester(mixture (2S,5R)/(2S,5S) 50/50) described in application FR2921060 (2kg, 4.65 mol) in water (12 L) and ethyl acetate (10 L). The aqueousphase is separated and then re-extracted with ethyl acetate (8 L). Theorganic phases are combined, washed with water (4 L) and then dried oversodium sulphate (2 kg). The solution is filtered and then concentratedin order to replace the ethyl acetate with acetonitrile (35 L). Thesolution is cooled to 0-5° C. before adding triethylamine (1.25 L) andthen diphosgene (290 mL). The reaction mixture is stirred at 0-5° C. forone hour before adding N,N-dimethylaminopyridine (270 g). After stirringfor two hours at room temperature, the reaction mixture is concentratedand then diluted with dichloromethane (15 L). The solution is added to a20% aqueous solution of ammonium chloride (15 L). The organic phase isisolated. The aqueous phase is re-extracted with dichloromethane (4 L).The organic phases are combined, dried over sodium sulphate andconcentrated to dryness to produce the expected compound (1645 g, yield96% as is, weight/weight).

In stage B, benzoxuracid or(1R,2S,5R)-7-oxo-6-(phenylmethoxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxylicacid and its cyclohexylamine salt is prepared. A solution of lithiumhydroxide (79.2 g, 3.3 mol) in water (3.3 L) is added in 30 minutes to astirred solution at 0-5° C. of the compound obtained in Stage A (1.028kg, 2.80 mol) in water (10.3 L) and tetrahydrofuran (1.5 L). Thereaction mixture is stirred for 1.5 h before adding a mixture ofisopropyl ether-ethyl acetate (8/2 vol/vol, 9.25 L). The aqueous phaseis isolated at room temperature. The organic phase is extracted withwater (2×2.57 L). The aqueous phases are combined and then washed with amixture of isopropyl ether-ethyl acetate (8/2 vol/vol, 2 L). The aqueoussolution is stirred with ethyl acetate (10.3 L), acidified with 2Nhydrochloric acid (1.9 L) to pH 2 and then saturated with sodiumchloride (4.8 kg). The aqueous phase is isolated and re-extracted withethyl acetate (5.14 L). The organic phases are combined and dried oversodium sulphate (1 kg). The solution is concentrated under vacuum at 40°C. to produce the expected compound (473 g, 61% yield as is,weight/weight).

The cyclohexylamine salt is prepared according to the method describedin Example 32b of Application WO 02/10172.

In stage C, benzoxuramide or(1R,2S,5R)-7-oxo-6-(phenylmethoxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxamidemay be prepared. This operation is carried out under the conditionsdescribed in Example 33a Stage A of Application WO 02/10172 startingwith the compound obtained in Stage B above to obtain the expectedcompound.

In stages D and E, sulphaturamide is prepared. This operation is carriedout starting with the compound obtained in Stage C above, under theconditions described in Example 33a Stage B and then Stage C and finallyin Example 33b of Application WO 02/10172. The expected compound isobtained in solid form.

In some embodiments, sodium salt of the amorphous(1R,2S,5R)-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxamideenantiomer may be prepared. For example, a solution of sulphaturamide(6.92 kg, 13.66 mol) in water (56 L) is eluted on a column of Dowex50WX8 resin (83 kg, 100-200 mesh) preconditioned by elution of anaqueous solution of sodium hydroxide and then washing with water until aneutral pH is reached. The fractions containing the product arecombined, filtered, weighed (76 kg net) and then lyophilized to producethe expected sodium salt in amorphous form (3.72 kg, yield 94.8%, HPLCpurity>99%).

WO 02/10172 describes the preparation of the racemic sodium salt oftrans-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide,which is obtained indirectly from a compound described in Example 33b ofWO 02/10172, by exchange of the tetrabutylammonium counter-ion withsodium, eluting an aqueous solution of the salt on ion exchange resin,treated beforehand with sodium hydroxide. The sodium salt is obtained insolid form, after elimination of the water. The racemic productcrystallizes as mentioned in Example 33c of WO 02/10172. Concentrationto dryness is carried out in the laboratory by evaporation. In practice,the water is removed by lyophilisation to obtain a homogeneous solidform. This solid form is hygroscopic and of low density, which makes itdifficult to handle and store, and consequently makes the methoddifficult to scale up to an industrial level. In itself, lyophilisationcarried out in the laboratory is already a technique that is difficultto scale up to the industrial level. Moreover, the method of ionexchange on resin that precedes it is expensive and of low productivityon account of the large amounts of resin, the dilution with water thatis necessary for quantitative ion exchange, the very long duration ofthe operation and the high energy costs required, and for these reasonsas well, the method is difficult to apply industrially.

The present invention relates to a novel and improved method ofpreparation of the sodium salt of the(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideenantiomer making it possible to obtain said salt in Perfectlycrystallized and stable form, without having recourse to the ionexchange technique nor to lyophilization under the conditions describedabove. The method according to the invention therefore offers the dualadvantage of simplifying the technique and thus permitting its scalingup to the industrial level, while supplying a crystallized form that isstable, and is easy to isolate, handle, store and formulate.

Compositions

The crystalline forms of the present invention can be administered aloneor in combination with an antibacterial agent, such as, for example,ceftaroline or a prodrug of ceftaroline. The present invention includespharmaceutical compositions comprising the crystalline forms of theinvention alone or in combination with an antibacterial agent, such as,for example, ceftaroline or a prodrug of ceftaroline. The compositionsmay further comprise one or more pharmaceutically acceptable carriers.

In one aspect, the present invention provides a composition comprising acrystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104). The crystalline form may be Form I, FormII, Form III, Form IV or Form V oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) as described above. In exemplaryembodiments, the compositions comprise Form 1. In other embodiments, thecomposition comprises Form II. In still other embodiments, thecompositions may comprise Form III, IV or V.

In specific embodiments, the compositions comprise a crystalline form ofsodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.For example, the compositions may comprise Form I. In other examples,the compositions may comprise Form II. In still other examples, thecompositions may comprise Form III, Form IV or Form V.

The compositions comprisingtrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) may comprise related substances that areprocess impurities or degradants of NXL-104. For example, thecompositions may comprise a decarbonyl compound or a disulfate compound.

In some embodiments, the compositions may comprise a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and less than about 2% of a decarbonylcompound of formula (I):

In some embodiments, the compositions comprise about 0.05% to about 1.5%of the decarbonyl compound. In exemplary embodiments, the compositionscomprise about 0.05 to about 1.0% of the decarbonyl compound. In otherexemplary embodiments, the compositions comprise between about 0.05 toabout 0.5% of the decarbonyl compound. For example, the compositions maycomprise about 0.1, about 0.2, about 0.3, about 0.4 or about 0.5% of thedecarbonyl compound.

In some embodiments, the compositions may comprise the crystalline formand less than about 2% of a disulfate compound of the formula (II):

In some embodiments, the compositions may comprise a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and ceftaroline or a prodrug of ceftaroline.The prodrug of ceftaroline may be a phosphono prodrug, such as,ceftaroline fosamil. The ceftaroline fosamil may be anhydrous. In otherembodiments, the ceftaroline fosamil may be a monohydrate. In stillother embodiments, the ceftaroline fosamil may be a solvate, such as, anacetic acid solvate or a propionic acid solvate.

In exemplary embodiments, the compositions may comprise Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and ceftaroline fosamil. In other exemplaryembodiments, the compositions may comprise Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and ceftaroline fosamil. In still otherexemplary embodiments, the compositions may comprise Form III, IV or Vof trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and ceftaroline fosamil.

In some embodiments, the compositions may comprise a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and ceftaroline fosamil and less than about10% of total impurities. The impurities may include, but are notlimited, to process impurities and degradants of the crystalline form orceftaroline fosamil. The impurities related to the crystalline forminclude decarbonyl compound of Formula (I) and disulfate compound ofFormula (II).

The impurities related to ceftaroline fosamil include ceftarolinerelated substances that may be process impurities or degradants ofceftaroline fosamil. Examples of such ceftaroline fosamil relatedsubstances are listed below.

U1 refers to ring opened ceftaroline of Formula (III):

U2 refers to diphosphoric-type ceftaroline of Formula (IV):

U3 refers to ceftaroline (active metabolite) of Formula (V):

U4 refers to dimer of ceftaroline acetate of Formula (VI):

U5 refers to delta 2-type ceftaroline acetate of Formula (VII):

U6 refers to a ring-opened ceftaroline of Formula (VIII):

U7 refers to amide-type U-1 of Formula (IX):

U8 refers to des-methyl-type ceftaroline acetate of Formula (X):

U9 refers to acetyl-type ceftaroline acetate of Formula (XI):

Adduct refers to an adduct of ceftaroline and L-arginine of Formula(XII)

In some embodiments, the compositions comprise a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and ceftaroline fosamil and less than about1 to 10% of impurities. In specific embodiments, the compositions maycomprise about 0.05 to about 10% of impurities.

In exemplary embodiments, the compositions may comprise less than 5% ofimpurities. For example, the compositions may comprise less than 0.6%U1; less than 0.6% U2, less than 5% U3, less than 0.2% U4, less than0.2% U5, less than 0.6% U6, less than 0.2% U7, less than 0.2% U8, lessthan 1.0% U9, or less than 1.5% adducts.

In exemplary embodiments, the compositions comprise about 0.05 to about0.2% of U4, U5, U7 or U8. In other exemplary embodiments, thecompositions comprise about 0.05 to about 0.6% of U1, U2 or U6. In stillother exemplary embodiments, the compositions comprise about 0.05 toabout 1% of U9. In certain embodiments, the compositions comprise about0.05 to about 5% of U9. In other embodiments, the compositions compriseabout 0.05 to about 1.5% of adduct.

The present invention provides formulations comprising about 200 mg to1200 mg of a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora salt thereof (e.g., NXL-104) that provide an in vivo plasma profilefor the crystalline form comprising a mean Cmax of less than about 100ug/ml. For example, the plasma profile comprises a mean Cmax of lessthan about 80 ug/ml; about 70 ug/ml; about 60 ug/ml; about 50 ug/ml;about 40 ug/ml or about 30 ug/ml. In exemplary embodiments, the plasmaprofile comprises a mean Cmax of about 10 to about 50 ug/ml. In otherembodiments, the plasma profile comprises a mean Cmax of about 20 toabout 40 ug/ml.

In further embodiments, the present invention provides compositionscomprising about 200 mg to 1200 mg ceftaroline fosamil that provide anin vivo plasma profile for ceftaroline comprising a mean Cmax of lessthan about 100 ug/ml. For example, the plasma profile comprises a meanCmax of less than about 80 ug/ml; about 70 ug/ml; about 60 ug/ml; about50 ug/ml; about 40 ug/ml or about 30 ug/ml. In exemplary embodiments,the plasma profile comprises a mean Cmax of about 10 to about 50 ug/ml.In other embodiments, the plasma profile comprises a mean Cmax of about10 to about 40 ug/ml.

The present invention provides formulations comprising about 200 mg to1200 mg of a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora salt thereof (e.g., NXL-104) that provide an in vivo plasma profilefor the crystalline form comprising a mean AUC_(0-∞) of more than about10 ug h/ml. For example, the plasma profile comprises a mean AUC_(0-∞)of about 10 to 500 ug h/ml; about 10 to 400 ug h/ml ug h/ml; about 10 to300 ug h/ml; about 10 to 200 ug h/ml or about 10 to 100 ug h/ml. Inexemplary embodiments, the plasma profile comprises a mean AUC_(0-∞) ofabout 10 to 200 ug h/ml. In further embodiments, the present inventionprovides compositions comprising about 200 mg to 1200 mg ceftarolinefosamil that provide an in vivo plasma profile for ceftarolinecomprising a mean AUC_(0-∞) of more than about 10 ug h/ml. For example,the plasma profile comprises a mean AUC_(0-∞) of about 10 to 500 ugh/ml; about 10 to 400 ug h/ml ug h/ml; about 10 to 300 ug h/ml; about 10to 200 ug him′ or about 10 to 100 ug h/ml. In exemplary embodiments, theplasma profile comprises a mean AUC_(0-∞) of about 10 to 200 ug h/ml.

The present invention provides formulations comprising about 200 mg to1200 mg of a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora salt thereof (e.g., NXL-104) that provides an in vivo plasma profilefor the crystalline form comprising a mean Tmax of more than about 10min. For example, the plasma profile comprises a mean Tmax of more thanabout 15 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours or about 2hours. In exemplary embodiments, the plasma profile comprises a meanTmax of about 30 minutes to about 2 hours. In further embodiments, thepresent invention provides compositions comprising about 200 mg to 1200mg ceftaroline fosamil that provide an in vivo plasma profile forceftaroline comprising a mean Tmax of more than about 10 min. Forexample, the plasma profile comprises a mean Tmax of more than about 15minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours or about 2 hours. Inexemplary embodiments, the plasma profile comprises a mean Tmax of about30 minutes to about 2 hours.

The compositions may comprise the crystalline forms in combination withother antibacterial agents. Some examples of antibacterial agents thatmay be combined with the crystalline forms, include, but are not limitedto, antibiotics of the β-lactamine type, for example, penams, penems,cephems, carbacephems, oxacephems, cephamycins, penicillins such asamoxicillin, ampicillin, azlocillin, mezlocillin, apalcillin,hetacillin, bacampicillin, carbenicillin, sulbenicillin, ticarcillin,piperacillin, mecillinam, pivmecillinam, methicillin, ciclacillin,talampicillin, aspoxicillin, oxacillin, cloxacillin, dicloxacillin,flucloxacillin, nafcillin or pivampicillin, cephalosporins such ascephalothin, cephaloridine, cefaclor, cefadroxil, cefamandole,cefazolin, cephalexin, cephradine, ceftizoxime, cefoxitin, cephacetrile,cefotiam, cefotaxime, cefsulodin, cefoperazone, ceftizoxime,cefmenoxime, cefmetazole, cephaloglycin, cefonicid, cefodizime,cefpirome, ceftazidime, ceftriaxone, cefpiramide, cefbuperazone,cefozopran, cefepime, cefoselis, cefluprenam, cefuzonam, cefpimizole,cefclidin, cefixime, ceftibuten, cefdinir, cefpodoxime axetil,cefpodoxime proxetil, cefteram pivoxil, cefetamet pivoxil, cefcapenepivoxil, or cefditoren, pivoxil, cefuroxime, cefuroxime axetil,loracarbacef or latamoxef, carbapenems such as imipenem, meropenem,biapenem or panipenem and also monobactams such as aztreonam andcarumonam, as well as their salts.

In exemplary embodiments, the compositions may comprise the crystallineform in combination with an antibacterial agent, such as, ceftazidime.For example, the compositions may comprise Form I and ceftazidime, FormII and ceftazidime, Form III and ceftazidime, Form IV and ceftazidime orForm V and ceftazidime.

Numerous standard references are available that describe procedures forpreparing various compositions suitable for administering the compoundsaccording to the invention. Examples of potential compositions andpreparations are contained, for example, in the Handbook ofPharmaceutical Excipients, American Pharmaceutical Association (currentedition); Pharmaceutical Dosage Forms: Tablets (Lieberman, Lachman andSchwartz, editors) current edition, published by Marcel Dekker, Inc., aswell as Remington's Pharmaceutical Sciences (Arthur Osol, editor),1553-1593 (current edition).

The compositions may be solid or liquid and be presented in thepharmaceutical forms, such as for example, plain or sugar-coatedtablets, gelatin capsules, granules, suppositories, injectablepreparations, ointments, creams, gels, and prepared according to theusual methods. The active ingredient or ingredients can be incorporatedwith excipients usually employed in these pharmaceutical compositions,such as talc, gum arabic, lactose, starch, magnesium stearate, cocoabutter, aqueous or non-aqueous vehicles, fatty substances of animal orvegetable origin, paraffin derivatives, glycols, various wetting,dispersing or emulsifying agents and preservatives.

Various solid oral dosage forms can be used for administering thecrystalline forms of the invention including such solid forms astablets, gelcaps, capsules, caplets, granules, lozenges and bulkpowders. The crystalline forms of the present invention can beadministered alone or combined with various pharmaceutically acceptablecarriers, diluents (such as sucrose, mannitol, lactose, starches) andexcipients known in the art, including, but not limited to suspendingagents, solubilizers, buffering agents, binders, disintegrants,preservatives, colorants, flavorants, lubricants and the like. Timerelease capsules, tablets and gels may also be used in administering thecrystalline forms of the present invention.

Various liquid oral dosage forms can also be used for administering thecrystalline forms of the inventions, including aqueous and non-aqueoussolutions, emulsions, suspensions, syrups, and elixirs. Such dosageforms can also contain suitable inert diluents known in the art such aswater and suitable excipients known in the art such as preservatives,wetting agents, sweeteners, flavorants, as well as agents foremulsifying and/or suspending the compounds of the invention. Thecrystalline forms of the present invention may be injected, for example,intravenously, in the form of an isotonic sterile solution. Otherpreparations are also possible.

The compositions may also be presented in the form of a lyophilisateintended to be dissolved extemporaneously in an appropriate vehicle,e.g., apyrogenic sterile water.

Suppositories for rectal administration of the crystalline forms of thepresent invention can be prepared by mixing the compound with a suitableexcipient such as cocoa butter, salicylates and polyethylene glycols.

For topical administration, the pharmaceutical composition can be in theform of creams, ointments, liniments, lotions, emulsions, suspensions,gels, solutions, pastes, powders, sprays, and drops suitable foradministration to the skin, eye, ear or nose. Topical administration mayalso involve transdermal administration via means such as transdermalpatches.

Aerosol formulations suitable for administering via inhalation also canbe made. For example, for treatment of disorders of the respiratorytract, the compounds according to the invention can be administered byinhalation in the form of a powder (e.g., micronized) or in the form ofatomized solutions or suspensions. The aerosol formulation can be placedinto a pressurized acceptable propellant.

Methods of Treatment

In one aspect, the present invention provides methods of treatingbacterial infections comprising administering a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt alone (e.g., NXL-104) or in combination with anantibacterial agent, such as, ceftaroline or a prodrug of ceftaroline.

The bacterial infections include, but are not limited to, complicatedskin and structure infection, community acquired pneumonia, complicatedurinary tract infections and complicated intra-abdominal infections(cIAIs). Complicated intra-abdominal infections include infectionsrequiring surgical intervention and infections that extend beyond thehollow viscus into the peritoneal space.

In some embodiments, the community acquired pneumonia may be due to amicroorganism, such as, Streptococcus, Staphylococcus, Haemophilus,Klebsiella, Escherichia and Moraxella. In further embodiments, thecommunity acquired bacterial pneumonia may be due to a microorganism,including, but not limited to, Streptococcus pneumoniae, Staphylococcusaureus, Haemophilus influenzae, Haemophilus parainfluenzae, Klebsiellapneumoniae, Escherichia coli and Moraxella catarrhalis. In otherembodiments, the community acquired pneumonia may be due toEnterobacter, Proteus or Serratia. In further embodiments, the communityacquired bacterial pneumonia may be due to Enterobacter aerogenes,Proteus mirabilis or Serratia marcescens.

In exemplary embodiments, the microorganism may be Streptococcuspneumoniae. The strain of Streptococcus pneumoniae may bepenicillin-susceptible, penicillin-resistant or multidrug resistant. Inexemplary embodiments, the microorganism may be Streptococcus pneumoniaeserotype 19A. In some embodiments, the community acquired pneumonia maybe associated with concurrent bacteremia. In other exemplaryembodiments, the microorganism may be Staphylococcus aureus. The strainor isolate of Staphylococcus aureus may be methicillin-susceptible ormethicillin-resistant. In still other exemplary embodiments, themicroorganism may be Haemophilus influenzae, Klebsiella pneumoniae orEscherichia coli. In exemplary embodiments, the microorganism may be aβ-lactamase-nonproducing ampicillin-resistant (BLNAR) strain ofHaemophilus influenzae.

In some embodiments, the methods comprise administering one or more ofthe crystalline forms oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104), for example, Form I, II, III, IV or V asdescribed above. In exemplary embodiments, the methods compriseadministering Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt. In other exemplary embodiments, the methods compriseadministering Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt. In still other exemplary embodiments, the methods compriseadministering Form III, IV or V oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt.

Some examples of antibacterial agents that may be administered incombination with the crystalline forms described in this application,include, but are not limited to, antibiotics of the β-lactamine type,for example, penams, penems, cephems, carbacephems, oxacephems,cephamycins, penicillins such as amoxicillin, ampicillin, azlocillin,mezlocillin, apalcillin, hetacillin, bacampicillin, carbenicillin,sulbenicillin, ticarcillin, piperacillin, mecillinam, pivmecillinam,methicillin, ciclacillin, talampicillin, aspoxicillin, oxacillin,cloxacillin, dicloxacillin, flucloxacillin, nafcillin or pivampicillin,cephalosporins such as cephalothin, cephaloridine, cefaclor, cefadroxil,cefamandole, cefazolin, cephalexin, cephradine, ceftizoxime, cefoxitin,cephacetrile, cefotiam, cefotaxime, cefsulodin, cefoperazone,ceftizoxime, cefmenoxime, cefmetazole, cephaloglycin, cefonicid,cefodizime, cefpirome, ceftazidime, ceftaroline or a prodrug thereofsuch as ceftaroline fosamil, ceftriaxone, cefpiramide, cefbuperazone,cefozopran, cefepime, cefoselis, cefluprenam, cefuzonam, cefpimizole,cefclidin, cefixime, ceftibuten, cefdinir, cefpodoxime axetil,cefpodoxime proxetil, cefteram pivoxil, cefetamet pivoxil, cefcapenepivoxil, or cefditoren, pivoxil, cefuroxime, cefuroxime axetil,loracarbacef or latamoxef, carbapenems such as imipenem, meropenem,biapenem or panipenem and also monobactams such as aztreonam andcarumonam, as well as their salts.

In exemplary embodiments, the methods include administering thecrystalline forms in combination with ceftazidime. In specificembodiments, Form) may be combined with ceftazidime. In otherembodiments, Form II may be combined with ceftazidime. In still otherembodiments, Form III may be combined with ceftazidime. In otherexamples, Form IV or V may be combined with ceftazidime.

In some embodiments, the methods comprise administering a compositioncomprising a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) as described above. The composition mayfurther comprise an antibacterial agent, e.g., ceftaroline fosamil asdescribed above.

In other embodiments, the methods comprise administering a crystallineform oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and an antibacterial agent, such as,ceftaroline or a prodrug of ceftaroline. The prodrug of ceftaroline maybe a phosphono prodrug, such as, ceftaroline fosamil. In exemplaryembodiments, the methods comprise administering Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and ceftaroline fosamil. In other exemplary embodiments, themethods comprise administering Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and ceftaroline fosamil. In still other exemplaryembodiments, the methods comprise administering Form III, IV or V andceftaroline fosamil.

The crystalline forms of the present invention can be administered atthe same time as the dose of an antibacterial agent, or separately. Inexemplary embodiments, the crystalline form may be administered incombination with the antibacterial agent, e.g., ceftaroline fosamil inone composition. In other embodiments, a composition comprising thecrystalline form may be administered concurrently with a compositioncomprising the antibacterial agent (e.g., ceftaroline fosamil).

The dose of the crystalline forms may vary according to several factors,including, but not limited to the type of bacterial infection and themicroorganism causing the infection.

In some embodiments, the daily dose of the crystalline form may rangefrom about 0.1 to approximately about 10 g. In specific embodiments, thedaily dose of the crystalline form may be about 100 mg to 10 g. In otherembodiments, the daily dose of the crystalline form may be about 200 mgto 5 g. In still other embodiments, the daily dose of the crystallineform may be about 200 mg to 2000 mg. In exemplary embodiments, the dailydose of the crystalline form may be about 200 mg, about 300 mg, about400 mg, about 500 mg, about 600 mg, about 700 mg, about 800 mg, about900 mg, about 1000 mg, about 1100 mg, about 1200 mg, about 1300 mg,about 1400 mg, about 1500 mg, about 1600 mg, about 1700 mg, about 1800mg, about 1900 mg and about 2000 mg. In some exemplary embodiments, thedaily dose is 500 mg. In other exemplary embodiments, the daily dose is800 mg. In still other exemplary embodiments, the daily dose is 1200 mg.

In some embodiments, the methods comprise administering the crystallineform in combination with about 100 mg and about 2400 mg of ceftarolineor a prodrug thereof (e.g., ceftaroline fosamil). In furtherembodiments, ceftaroline or a prodrug thereof may be administered in anamount between about 100 mg and about 1200 mg. In some embodiments,ceftaroline or a prodrug thereof may be administered in an amountbetween about 200 mg and 1000 mg. In exemplary embodiments, the amountmay be about 100 mg, 200 mg, 300 mg, 400 mg, 500 mg, 600 mg, 700 mg, 800mg, 900 mg, 1000 mg, 1100 mg or 1200 mg. In certain embodiments, theamount may be about 400 mg. In other embodiments, the amount may beabout 600 mg. In still other embodiments, the amount may be about 800mg. In certain embodiments, the amount may be about 1200 mg.

In some embodiments, the methods comprise administering the crystallineform in combination with between about 100 mg and about 2400 mg ofceftazidime. In further embodiments, ceftazidime may be administered inan amount between about 100 mg and about 1200 mg. In some embodiments,ceftazidime may be administered in an amount between about 200 mg and1000 mg. In exemplary embodiments, the amount may be about 100 mg, 200mg, 300 mg, 400 mg, 500 mg, 600 mg, 700 mg, 800 mg, 900 mg, 1000 mg,1100 mg or 1200 mg. In certain embodiments, the amount may be about 500mg. In other embodiments, the amount of ceftazidime may be between about1 g and about 3 g. In some embodiments, the amount may be about 1 g. Inother embodiments, the amount may be about 2 g. In still otherembodiments, the amount may be about 3 g. In some embodiments, theamount may be between about 4 g and 6 g, for example, about 4 g, about 5g or about 6 g.

The amount of the crystalline form and antibacterial agent may beadministered in a single dose or multiple divided doses per day. Forexample, the amount may be administered as a single daily dose.

In exemplary embodiments, about 800 mg of Form I, 11, III, IV or V oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt may be administered daily with about 800 mg of ceftarolineor a prodrug thereof (e.g., ceftaroline fosamil). In other exemplaryembodiments, about 1200 mg of Form I, II, III, IV or V oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt may be administered daily with about 1200 mg of ceftarolineor a prodrug (e.g., ceftaroline fosamil) thereof. In some embodiments,the amount may be administered in two to eight doses per day. Forexample, about 400 mg of the crystalline form and about 400 mg ofceftaroline or a prodrug thereof (e.g., ceftaroline fosamil) may beadministered every 12 hours (i.e. twice a day). In some examples, about600 mg of the crystalline form and about 600 mg of ceftaroline or aprodrug thereof (e.g., ceftaroline fosamil) may be administered every 12hours (i.e. twice a day).

In some embodiments, the ratio of the crystalline form to theantibacterial agent may range from about 1:20 to about 10:1. The ratiomay vary according to the type of infection and the antibacterial agent.In exemplary embodiments, the ratio of crystalline form to antibacterialagent may be between about 1:10 to 5:1.

In specific embodiments, the methods comprise administering thecrystalline form in combination with ceftaroline or a prodrug ofceftaroline, such as, ceftaroline fosamil. In exemplary embodiments, themethods include administering the crystalline form and ceftarolinefosamil in a ratio of about 1:1 to 5:1, such as, for example, 1:1, 2:1,3:1, 4:1, 5:1. In exemplary embodiments, the methods compriseadministering Form I, II, III, IV or V oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (e.g., NXL-104) and ceftaroline fosamil in a ratio of 1:1.For example, about 400 mg of Form I may be administered in combinationwith about 400 mg of ceftaroline fosamil. In some embodiments, about 600mg of Form I may be administered with about 600 mg of ceftarolinefosamil.

The crystalline forms of the present invention may be administeredaccording to patient needs, for example, orally, nasally, parenterally,by inhalation, rectally, vaginally, topically and by ocularadministration. Parenteral administration may be intravenous,intra-arterial, intrathecal, intramuscular, subcutaneous, intramuscular,intrasternal or intra-abdominal (e.g., intraperitoneal) etc. In someembodiments, the parenteral administration may be effected by infusionpumps (external or implantable) or any other suitable means appropriateto the desired administration modality.

In exemplary embodiments, the crystalline form and ceftaroline or aprodrug thereof may be administered parenterally. Suitable methods forparenteral administration include, but are not limited to, administeringa sterile aqueous preparation of the crystalline form alone or incombination with an antibacterial agent, which preferably is isotonicwith the blood of the recipient (e.g., physiological saline solution).Such preparations may include suspending agents and thickening agentsand liposomes or other microparticulate systems, which are designed totarget the compound to blood components or one or more organs. Thepreparation may be presented in a unit-dose or multi-dose form.

Ceftaroline or a prodrug thereof (e.g., ceftaroline fosamil) may beadministered as a solution or suspension in a solvent, such as water,physiological saline, about a 5% to about 10% sugar (e.g., glucose,dextrose) solution, and combinations thereof. In exemplary embodiments,ceftaroline or a prodrug thereof may be administered intravenously, suchas, by infusion. In some embodiments, ceftaroline or a prodrug thereofmay be administered by intravenous infusion over one hour. In otherembodiments, ceftaroline or a prodrug thereof may be administeredthrough continuous or prolonged intravenous infusion. In still otherembodiments, ceftaroline or a prodrug thereof may be administeredintramuscularly. For intramuscular administration of higher doses, theinjection may occur at two or more intramuscular sites.

In some embodiments, methods of treating community acquired pneumoniamay include administering ceftaroline or a prodrug thereof every 4hours, 6 hours, 8 hours, 12 hours, 18 hours or every 24 hours. Forexample, ceftaroline or a prodrug thereof may be administered every 12hours intravenously by infusion over one hour. In other embodiments, themethods may include administering ceftaroline or a prodrug thereofthrough continuous or prolonged infusion. For example, ceftaroline or aprodrug thereof may be administered by infusion over 2 hours, 3 hours, 4hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, 10 hours, 11 hoursor 12 hours. In other embodiments, the duration of infusion may be morethan 12 hours, e.g., 13 hours, 14 hours, 15 hours, 16 hours, 17 hours,18 hours, 19 hours, 20 hours, 21 hours or 22 hours, 23 hours or 24hours. For example, about 400 mg of ceftaroline or a prodrug thereof maybe administered by infusion over 12 hours. In another example, about 600mg of ceftaroline or a prodrug thereof may be administered by infusionover 12 hours.

The duration of treatment may depend on the severity and site ofinfection and the subject's clinical and bacteriological progress. Insome embodiments, the treatment may last between about 5 to 14 days. Inother embodiments, the treatment may last between about 5 to 7 days. Forexample, about 400 mg of ceftaroline or a prodrug thereof may beadministered every 24 hours for five to fourteen days. In furtherembodiments, about 400 mg of ceftaroline or a prodrug thereof may beadministered every 24 hours for five to ten, days. In other embodiments,about 400 mg of ceftaroline or a prodrug thereof may be administeredevery 24 hours for five to seven days.

In other embodiments, about 400 mg of ceftaroline or a prodrug thereofmay be administered every 12 hours for five to fourteen days. In otherembodiments, about 400 mg of ceftaroline or a prodrug thereof may beadministered every 12 hours for five to ten days. In still otherembodiments, about 400 mg of ceftaroline or a prodrug thereof may beadministered every 12 hours for five to seven days.

In other embodiments, about 400 mg of ceftaroline or a prodrug thereofmay be administered every 8 hours for five to fourteen days. Forexample, about 400 mg of ceftaroline or a prodrug thereof may beadministered every 8 hours for five to ten days. In further embodiments,about 400 mg of ceftaroline or a prodrug thereof may be administeredevery 8 hours for five to seven days.

In other embodiments, about 600 mg of ceftaroline or a prodrug thereofmay be administered every 24 hours for five to fourteen days. Forexample, about 600 mg of ceftaroline or a prodrug thereof may beadministered every 24 hours for five to ten days. In exemplaryembodiments, about 600 mg of ceftaroline or a prodrug thereof may beadministered every 24 hours for five to seven days. In some embodiments,about 600 mg of ceftaroline or a prodrug thereof may be administeredevery 12 hours for five to fourteen days. In other embodiments, about600 mg of ceftaroline or a prodrug thereof may be administered every 12hours for five to ten days. In still other embodiments, about 600 mg ofceftaroline or a prodrug thereof may be administered every 12 hours forfive to seven days. In further embodiments, about 600 mg of ceftarolineor a prodrug thereof may be administered every 8 hours for five tofourteen days. In some embodiments, about 600 mg of ceftaroline or aprodrug thereof may be administered every 8 hours for five to ten days.In other embodiments, about 600 mg of ceftaroline or a prodrug thereofmay be administered every 8 hours for five to seven days.

Unless defined otherwise, all technical and scientific terms used hereingenerally have the same meaning as commonly understood by one ofordinary skill in the art to which this invention belongs.

NXL-104 refers to the monosodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.The structure of NXL-104 is as shown below:

The term “prodrug” means a compound that is a drug precursor, which uponadministration to a subject undergoes chemical conversion by metabolicor chemical processes to yield a compound, which is an active moiety.Suitable prodrugs of ceftaroline include, but are not limited to,phosphonocepehem derivatives, such as, e.g.,7β-[2(Z)-ethoxyimino-2-(5-phosphonoamino-1,2,4-thiadiazol-3-yl)acetamido]-3-[4-(1-methyl-4-pyridinio)-2-thiazolythio]-3-cephem-4-carboxylate.

Solvates of a compound may form when a solvent molecule(s) isincorporated into the crystalline lattice structure of ceftaroline or aprodrug thereof molecule during, for example, a crystallization process.Suitable solvates include, e.g., hydrates (monohydrate, sesquihydrate,dihydrate), solvates with organic compounds (e.g., CH₃CO₂H, CH₃CH₂CO₂H,CH₃CN), and combinations thereof.

The term “substantially pure” means a compound having a purity greaterthen, e.g., about 90% by weight, for example, greater than about 91% byweight, greater than about 92% by weight, greater than about 93% byweight, greater than about 94% by weight, greater than about 95% byweight, greater than about 96% by weight, greater than about 97% byweight, greater than about 97.5% by weight, greater than about 98% byweight, greater than about 99% by weight, greater than about 99.5% byweight, or greater than about 99.9% by weight.

The term “about” or “approximately” means within an acceptable errorrange for the particular value as determined by one of ordinary skill inthe art, which will depend in part on how the value is measured ordetermined, i.e., the limitations of the measurement system. Forexample, “about” can mean within 1 or more than 1 standard deviation,per practice in the art. Alternatively, “about” with respect to thecompositions can mean plus or minus a range of up to 20%, preferably upto 10%, more preferably up to 5%. Alternatively, particularly withrespect to biological systems or processes, the term can mean within anorder of magnitude, preferably within 5-fold, and more preferably within2-fold, of a value. Where particular values are described in theapplication and claims, unless otherwise stated the term “about” meanswithin an acceptable error range for the particular value. For example,when referring to a period of time, e.g., hours, the present values(±20%) are more applicable. Thus, 6 hours can be, e.g., 4.8 hours, 5.5hours, 6.5 hours, 7.2 hours, as well as the usual 6 hours.

The terms “treat,” “treatment,” and “treating” refer to one or more ofthe following: relieving or alleviating at least one symptom of abacterial infection in a subject; relieving or alleviating the intensityand/or duration of a manifestation of bacterial infection experienced bya subject; and arresting, delaying the onset (i.e., the period prior toclinical manifestation of infection) and/or reducing the risk ofdeveloping or worsening a bacterial infection.

The term “community acquired pneumonia” as used herein is equivalent andhas been used interchangeably with the term “community acquiredbacterial pneumonia.”

The term “therapeutically effective” applied to dose or amount refers tothat quantity of a compound or pharmaceutical composition that issufficient to result in a desired activity upon administration to amammal in need thereof. An “effective amount” means the amount of acompound according to the invention that, when administered to a patientfor treating an infection or disease is sufficient to effect suchtreatment. The “effective amount” will vary depending on the activeingredient, the state of infection, disease or condition to be treatedand its severity, and the age, weight, physical condition andresponsiveness of the mammal to be treated.

MPTT refers to 4-(1-methylpyridin-1-ium-4-yl)thiazole-2-thiol.

In the examples, ND refers to a not detectable (quantity) and UNK refersto an unknown impurity and w/o U3 refers to total impurities without U3.

In some embodiments, the compounds of the present invention areadministered as a mono-therapy. In other embodiments, the compounds ofthe present invention are administered as part of a combination therapy.For example, a compound of the invention may be used in combination withother drugs or therapies that are used in thetreatment/prevention/suppression or amelioration of the diseases orconditions for which compounds of the invention are useful.

Such other drug(s) may be administered, by a route and in an amountcommonly used therefore, contemporaneously or sequentially with acompound of the invention. When a compound of the present invention isused contemporaneously with one or more other drugs, a pharmaceuticalunit dosage form containing such other drugs in addition to the compoundof the invention may be employed. Accordingly, the pharmaceuticalcompositions of the present invention include those that also containone or more other active ingredients, in addition to a compound ofinvention.

The following examples are merely illustrative of the present inventionand should not be construed as limiting the scope of the invention inany way as many variations and equivalents that are encompassed by thepresent invention will become apparent to those skilled in the art uponreading the present disclosure.

EXAMPLES Example 1 Preparation and characterization of amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt

Amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidecan be prepared as described in U.S. Pat. No. 7,112,592. The XRD patternwas obtained by mounting samples on a sample holder of Rigaku MiniflexX-ray diffractometer with the Kα radiation of copper (λ=1.541 Å). Thesamples, without grinding, were put on a glass plate and were analyzedat ambient temperature and humidity. Data were collected at 0.05°interval, 2°/minute from 3°-40° 2θ. FIG. 1 shows the X-ray diffraction(XRD) pattern for amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt.

A solution, in a water-acetone mixture (1-1), of the sodium salt of theracemictrans-7-oxo-6-(sulphoxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxamidedescribed in Example 33c of Application WO 02/10172 is evaporated underreduced pressure, under the conditions of concentration described insaid example. The salt is obtained in crystallized form. The X-rayspectra (“XRPD diffraction patterns”) of the polymorphic Forms werecompared. The diffraction pattern of the racemic form obtained accordingto the prior art is different from each of those of the polymorphicForms.

Example 2 Preparation and characterization of Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt

Method I

A solution of the 5.067 g (10 mmoles) of the tetrabutylammonium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide in12.5 ml of 200 proof ethanol and 12.5 ml of 190 proof ethanol wasfiltered through a 1.6 μm filter and added to a 100 ml jacketed-reactorequipped with magnetic stirrer. The solution was warmed to an internaltemperature of 35° C. Separately, a solution of 3.3 g (20 mmoles) ofsodium 2-ethylhexanoate in 25 ml 200 proof ethanol was filtered througha 1.6 μm filter. 2.5 ml of this solution was added to the reactor andthe mixture was stirred for 1 h at 35° C. Crystallization occurredduring this time. The remainder of the sodium 2-ethylhexanoate solutionwas added over 20 min. The mixture was stirred for an additional 1 h at35° C., followed by 12 h at 25° C. The mixture was cooled to 0° C. for 2h. The crystals were isolated by filtration and washed with 10 mlethanol. The crystals were dried under vacuum at 35° C. for 16 h. 2.72 gof the sodium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide(Form I) was obtained, corresponding to a yield of 95%.

Method II

A solution of the 50.67 g (100 mmoles) of the tetrabutylammonium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide in338 ml of ethanol and 8.33 ml of water was filtered through a 0.45 μmfilter and added to a 1 liter jacketed-reactor equipped with overheadstirrer and internal temperature probe. The solution was warmed to aninternal temperature of 30° C. 287 mg (1 mmole) of Form I seed crystalswere added. A solution of 35.125 g (205 mmoles) of sodium2-ethylhexanoate in 338 ml ethanol was filtered through a 0.45 μm filterand added to the reactor over 4 h. The mixture was stirred an additional12 h at 30° C., then cooled to 5° C. for 4 h. The crystals were isolatedby filtration and washed with 40 ml ethanol three times. The crystalswere dried under vacuum at 20° C. for 4 h. 27.14 g of the sodium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide(Form I) was obtained, corresponding to a yield of 93.5%.

Method III

A solution of sodium 2-ethylhexanoate (13.12 g, 79 mmol) in ethanol (126mL) is added over five hours to a solution of sulphaturamide (20 g, 39.5mmol) in ethanol (126 mL) stirred at 30° C. and seeded with a fewcrystals of polymorphic Form I. The suspension is stirred overnight. Thesuspension is cooled to 0-5° C. for 1 to 2 hours, filtered and thenwashed with ethanol at 5° C. (3×40 mL). The crystals are dried underreduced pressure of 20 mbar at 20° C. The expected polymorphic Form I isobtained (10.79 g, 37.5 mmol, yield 95.1%).

Method IV

A solution of sulphaturamide (10 g, 19.7 mmol) in ethanol (100 ml) isadded over forty-five minutes to a solution of sodium 2-ethylhexanoate(3.80 g, 22.9 mmol) in ethanol (95 ml) and water (5 ml; 3.1% of thetotal weight of the solvent), stirred at room temperature and seededwith a few crystals of polymorphic Form II. The suspension is stirredovernight. The suspension is cooled down to 0-5° C. for 1 to 2 hours,filtered and then washed with ethanol at 5° C. (3×30 ml). The crystalsare dried under reduced pressure of 20 mbar at 20° C. The polymorphicForm I is obtained (4.277 g, 14.9 mmol, yield 75.4%).

The XRD pattern was obtained as described in Example 1. FIG. 2 shows theXRD pattern for Form I.

Example 3 Preparation and characterization of Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt

Method I

A solution of the 10.134 g (20 mmoles) of the tetrabutylammonium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide in48.1 ml of isobutanol and 2.53 ml water was filtered through a 1.6 μMfilter and added to a 500 ml jacketed-reactor equipped with overheadstirrer and internal temperature probe. The solution was warmed to aninternal temperature of 35° C. A solution of 6.65 g (40 mmoles) ofsodium 2-ethylhexanoate in 49.5 ml isobutanol and 0.5 ml water wasfiltered through a 1.6 μm filter and added dropwise to the reactor.Crystallization occurred during the addition. The mixture was stirredfor an additional 1 h at 35° C. followed by 16 h at 25° C. The mixturewas cooled to 0° C. for 2 h. The crystals were isolated by filtrationand washed with an ice-cold mixture of 19.5 ml isobutanol and 0.5 mlwater. The crystals were dried under vacuum at 35° C. for 20 h. 5.48 gof the sodium salt oftrans-7-oxo-6-(sulfooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidemonohydrate (Form II) was obtained, corresponding to a yield of 90%.

Method II

A solution of sodium 2-ethylhexanoate (6.56 g, 39.4 mmol) in ethanol (70mL) is added over forty-five minutes to a solution of sulphaturamide (10g, 19.7 mmol) in a mixture of ethanol (63 mL) and water (7 mL, 6.23% ofthe total weight of the solvent), stirred at 20° C. and seeded with theForm II. The suspension is stirred overnight. The suspension is cooleddown to 0-5° C. for 1 to 2 hours, filtered and then washed with aqueousethanol (5%) cooled down to 5° C. (3×20 mL). The crystals are driedunder reduced pressure of 20 mbar at 20° C. The expected Form II isobtained (5.35 g, 17.5 mmol, yield 88.8%).

Method III

A solution of sulphaturamide (1 g, 1.97 mmol) in ethanol (9.5 ml) andwater (0.5 ml) is added over thirty minutes to a solution of sodium2-ethylhexanoate (0.506 g, 3.04 mmol) in ethanol (9.5 ml) and water (0.5ml). It is stirred at room temperature. The solution (6.23% of the totalweight of water) is seeded with a few crystals of Form II to produce asuspension, which is stirred overnight. The suspension is cooled down to0-5° C. for 1 to 2 hours, filtered and then washed with ethanol at 5° C.(3×6 ml). The crystals are dried under reduced pressure of 20 mbar at20° C. The expected Form II is obtained (0.378 g, 1.24 mmol, yield62.7%).

The XRD pattern was obtained as described in Example 1. FIG. 3 shows theXRD pattern for Form II.

Example 4 Preparation and characterization of Form III oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt

Form III can be made on mg scale by vortexing Form I (100 mg) in 0.9%aqueous sodium chloride solution (40 μl).

A sample of sodium salt of the(1R,2S,5R)-7-oxo-6-(sulphoxy)-1,6-diazabicyclo[3.2.1]octane-2-carboxamideenantiomer, monohydrate—Form II (1 g) is suspended in water (2 ml). Thesuspension, unstirred, is left to evaporate slowly at ambienttemperature, pressure and humidity. The crystallized solid is recoveredafter complete evaporation. The expected Form III is obtained (1.056 g).The XRD pattern was obtained as described in Example 1. FIG. 4 shows theXRD pattern for Form III.

Example 5 Preparation and characterization of Form IV oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt

Method I

Sulfaturamide (SU) is dissolved in ethanol (EtOH). Sodium2-ethylhexanoate (SEH), dissolved in ethanol, is added rapidly to SUsolution. SU, SEH and the byproduct (tetrabutylammonium ethylhexanoate)are all soluble in EtOH, but the sodium salt of NXL-104 has a poorsolubility and so crystallizes out of solution. Form IV is obtainedunder anhydrous conditions (anhydrous SU and SEH) and rapid addition ofSEH. Yield was 85% using this process.

Method II

A solution of sodium 2-ethylhexanoate (3.28 g, 19.7 mmol) in ethanol (25ml) is added over thirty minutes to a solution of sulphaturamide (4 g,9.87 mmol) in ethanol (25 ml), stirred at 20° C. and seeded with thepolymorphic form II. The suspension is stirred overnight. The suspensionis filtered and then washed with ethanol at 5° C. (3×10 ml). The solidis dried under reduced pressure of 20 mbar at 20° C. The expectedpolymorphic form IV is obtained (2.50 g, 8.70 mmol, yield 88.2%).

The XRD pattern was obtained as described in Example 1. FIG. 5 shows theXRD pattern for Form IV.

Example 6 Stability of amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104)

A solution containing 400 mg/ml (on free acid basis)trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt was prepared by dissolving the compound in water. Thesolution was then filled into 10 cc Type I glass vials and lyophilizedby freezing at −50° C. for 1-4 hours, primary drying at temperaturesranging from −25 to −10° C. for 30-50 hours and pressures from 100 to400 mTorr and secondary drying at 25° C. for 10-20 hours.

Assay for NXL-104 and Related Substances

NXL-104 and related substances in compositions comprisingtrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt were determined by a reverse phase gradient HPLC method withUV detection at 195 nm.

The following parameters were used for analysis:

Column: Inertsil ODS-3, 250 mm×4.6 mm, 5 μm

Mobile Phase A: 100 mM KH₂PO₄ Solution

Mobile Phase B: Acetonitrile: Water, [50:50 (v:v)]

Flow Rate: 1.0 ml/min

Column Temperature: 25° C.

Autosampler Temperature: 5° C.

Detector/Setting: UV/195 nm

Injection Volume: 10 μL

Run Time: about 25 minutes

Injector Washing Solution: Acetonitrile:Water, [10:90 (v:v)]

Approximate relative retention times (RRT) values fortrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and disulfate were 1.00 and 0.37.

The decarbonyl degradation product oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt was determined by a reverse phase gradient HPLC method withUV detection at 195 nm.

The following parameters were used for analysis:

Column: Inertsil ODS-3, 250 mm×4.6 mm, 5 μm

Mobile Phase A: Deionized Water

Mobile Phase B: 50 mM KH₂PO₄ solution: Acetonitrile, [50:50 (v:v)]

Flow Rate: 1.0 ml/min

Column Temperature: 25° C.

Detector/Setting: UV/195 nm

Injection Volume: 10 μL

Run Time (Approximate): 35 minutes

Injector Washing Solution: Acetonitrile: Water, [50:50 (v:v)](Recommended)

Approximate relative retention time (RRT) for decarbonyl was 0.17.

The stability of amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt stored in a vial stored at 25° C. with a relative humidityof 60% (25° C./60% RH) was evaluated using the NXL-104 assay describedabove.

Table 1 provides the stability data for amorphous NXL-104 in vial storedat 25° C./60% RH.

TABLE 1 Stability of amorphous NXL-104 in vial stored at 25° C./60% RHImpurities - NXL-104 Related (%) Total pH NXL-104% Decarbonyl DisulfateImpurities Initial 7.0 106.4 0.63 0.19 0.90 1 month 7.3 111.3 0.46 0.190.89 3 months 7.2 108.0 0.48 0.17 0.92 6 months 7.3 106.1 0.33 0.17 0.87

Example 7 Stability of amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104) and amorphous ceftaroline fosamil

A solution was prepared by dissolving ceftaroline fosamil monohydrateacetic acid solvate (668.4 mg/vial),trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (649.8 mg/vial) and L-Arginine (434.3 mg/vial) in Water forInjection, USP. The concentration of both ceftaroline fosamil (anhydrousand non-solvate) andtrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidefree acid was 120 mg/ml.

Lyophilization cycle was designed based on the glass transitiontemperatures of frozen solutions of ceftaroline fosamil monohydrateacetic acid solvate,trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and L-Arginine determined using Differential Scanningcalorimetry. 5 ml of the solution was filled into each 20 cc Type Iglass vial and lyophilized (Telstar LyoBeta25) by freezing at −50° C.for 1-5 hours, primary drying at temperatures ranging from −40 to −10°C. for 30-50 hours and pressures from 100 to 400 mTorr and secondarydrying at 25° C. for 10-20 hours. Intact lyophilized cakes were obtainedat the end of the process and the vials were stored at differentconditions to monitor stability.

NXL-104 and related substances were measured according to the assaydescribed in Example 6.

Assay for ceftaroline fosamil and related substances

Ceftaroline fosamil assay and related substances in compositionscomprisingtrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and ceftaroline fosamil were quantified by a gradient methodusing ultra high performance liquid chromatography (UPLC). Theanalytical wavelength setting was 245 nm.

The following parameters were used for analysis:

Analytical Column: Waters Acquity UPLC BEH C18 Column, 2.1×100 mm,

1.7 μm particle size

Guard Column: Waters Acquity UPLC BEH C18 VanGuard Pre-Column,

2.1×5 mm, 1.7 μm particle size

Mobile Phase A: 100 mM Ammonium Acetate:Acetonitrile (95:5, v:v)

Mobile Phase B: 100 mM Ammonium Acetate:Acetonitrile (60:40, v:v)

Flow Rate: 0.5 ml/min

Column Temperature: 40° C.

Detector: UV/245 nm

Injection Volume: 4 μL

Injection Type: Partial Loop with Needle Overfill

Weak Needle Wash Solution: Water:Acetonitrile (90:10, v:v)

Strong Needle Wash Solution: Methanol:Acetonitrile:Isopropanol:Water(25:25:25:25, v:v:v:v) with 0.1% Formic Acid

Seal Wash Solution: Water:Acetonitrile (95:5, v:v)

Run Time: about 12 minutes

Approximate relative retention times (RRT) for the ceftaroline relatedsubstances were as follows:

U1—0.31

U2—0.94

U3—1.57

U4—1.74

U6—0.80

U9—1.78

Adduct—0.66

Tables 2-4 show the stability data for composition comprising amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (NXL-104) and amorphous ceftaroline fosamil.

TABLE 2 NXL-104 and ceftaroline fosamil assay Ceftaroline pH NXL-104 %fosamil % t-zero 5.68 104.2 94.3 1 month at 40° C./75% RH 5.67 99.5 80.33 months at 25° C./60% RH 5.71 101.9 87.0

TABLE 3 NXL-104 related impurities (%) Decarbonyl Total Impuritiest-zero ND 0.17 1 month at 40° C./75% RH 0.23 1.32 3 months at 25° C./60%RH 0.23 0.91

TABLE 4 Ceftaroline related impurities (%) Total U1 Adduct U6 U4 U7 U3U9 Impurities t-zero 1.01 0.57 0.10 0.03 0.02 2.59 0.03 4.52 1 month at6.14 2.58 0.32 0.05 ND 3.62 0.09 14.88 40° C./75% RH 3 months at 4.021.98 0.22 <0.05 0.02 3.00 <0.05 12.96 25° C./60% RH

Amorphous Nxl-104 and Amorphous Ceftaroline Fosamil with Stabilizer

A solution was prepared by dissolving ceftaroline fosamil monohydrateacetic acid solvate (668.4 mg/vial),trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (649.8 mg/vial), L-Arginine and/or suitable buffer or otherstabilizer in Water for Injection, USP. The concentration of bothceftaroline fosamil (anhydrous and non-solvate) andtrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidefree acid was 120 mg/ml. Lyophilization cycle was designed based on theglass transition temperatures of frozen solutions of ceftaroline fosamilmonohydrate acetic acid solvate,trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and L-Arginine determined using Differential Scanningcalorimetry as well as the glass transition temperatures of frozensolutions of the buffer/other stabilizer. 5 ml of the solution wasfilled into 20 cc Type I glass vial and lyophilized (Telstar LyoBeta25)by freezing at −50° C. for 1-5 hours, primary drying at temperaturesranging from −40 to −10° C. for 40-80 hours and pressures from 100 to400 mTorr and secondary drying at 25° C. for 10-20 hours. Depending onthe formulation, an annealing step was also included before primarydrying in order to allow complete ice crystallization or crystallizationof excipients. Annealing temperature was between −20° C. and 0° C. andannealing time was 4-12 hours. Intact lyophilized cakes were obtained atthe end of the process and the vials were stored at different conditionsto monitor stability. Packaging components used were 20 ml Type I glassvial, Gray chlorobutyl-isoprene stopper and Blue Aluminum tear-off seal.

Tables 5-7 show the stability data for a formulation comprisinglyophilized ceftaroline fosamil (668.4 mg), arginine (434.3 mg), NXL-104(649.8 mg) and Kollidon17 (93 mg).

TABLE 5 NXL-104 and ceftaroline fosamil assay pH NXL-104 % Ceftarolinefosamil % t-zero 5.61 101.08 96.60 3 months at 5.43 93.2 72.4 40° C./75%RH

TABLE 6 NXL-104 related impurities (%) Decarbonyl Total Impuritiest-zero 0.61 0.76 3 months at 40° C./75% RH 0.20 3.91

TABLE 7 Ceftaroline fosamil related impurities (%) Total U1 Adduct U6 U2U3 U9 Impurities t-zero 1.37 0.76 0.19 0.11 3.28 0.25 6.72 3 months10.20 4.57 0.90 0.21 5.04 0.22 22.76 40° C./ 75% RH

Four formulations (1-4) comprising amorphoustrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and amorphous ceftaroline fosamil were prepared. Table 8shows the stability data for lyophilized Formulations 1-4.

Formulation 1 (Per Vial)

Ceftaroline fosamil acetate=668.4 mg

NXL-104=649.8 mg

L-Arginine=434.3 mg

Citric acid monohydrate=1.1 mg

Trisodium citrate dihydrate=27.9 mg

Formulation 2 (Per Vial)

Ceftaroline fosamil acetate=668.4 mg

NXL-104=649.8 mg

L-Arginine=243.6 mg

Citric acid monohydrate=1.1 mg

Trisodium citrate dihydrate=27.9 mg

Formulation 3 (Per Vial)

Ceftaroline fosamil acetate=668.4 mg

NXL-104=649.8 mg

L-Arginine=243.6 mg

Citric acid monohydrate=2.2 mg

Trisodium citrate dihydrate=55.8 mg

Formulation 4 (Per Vial)

Ceftaroline fosamil acetate=668.4 mg

NXL-104=649.8 mg

L-Arginine=434.3 mg

Tartaric acid=37.5 mg

Sodium hydroxide=4 mg

TABLE 8 Assay and degradation profile of lyophilized Formulations 1-4NXL-104 related Ceftaroline impurities (%) related NXL-104 CeftarolineTotal impurities (%) Formulation pH % fosamil %* Decarbonyl impuritiesU1 U3 1 5.79 101.80 92.36 0.19 0.44 1.11 2.89 2 4.73 99.96 91.83 0.320.76 0.76 4.60 3 4.77 101.19 93.93 0.28 0.85 0.73 4.00 4 5.28 101.8494.14 0.12 0.19 0.74 3.03 *Assay values adjusted based on 95.5% assay of“as is” ceftaroline fosamil acetate. Actual assay values were 88.20,87.70, 89.70 and 89.90 for Formulations 1, 2, 3 and 4 respectively.

Tables 9-12 show the assay and degradation profile of lyophilizedFormulation 1 stored at 40° C./75% RH for 2 weeks.

TABLE 9 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Assay Total impurities Assay Total pH (%)* U3 (w/o U3) (%) (%)impurities (%) 5.82 84.0 3.5 7.22 102.4 0.63 *Corrected value based onceftaroline fosamil acetate potency of 95.5%.

TABLE 10 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct 2.47 0.11 0.05 ND 0.13 ND ND 0.10 0.37 2.63 ND = Not detectable

TABLE 11 Ceftaroline related substances (%) UNK* UNK UNK UNK UNK UNK UNKUNK # 0.81 # 0.86 # 1.04 # 1.09 # 1.17 # 1.27 # 1.36 # 1.41 0.14 ND 0.590.14 0.12 ND ND ND UNK = unknown impurities

TABLE 12 NXL-104 related substances (%) Decarbonyl UNK # 0.30 UNK # 0.33UNK # 0.36 UNK # 0.37 0.21 0.14 0.12 0.16 ND

Tables 13-16 show the assay and degradation profile of lyophilizedFormulation 2 stored at 40° C./75% RH for 2 weeks.

TABLE 13 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamil TotalNXL-104 Assay impurities Assay Total pH (%)* U3 (w/o U3) (%) (%)impurities (%) 4.70 86.1 6.1 4.07 102.1 0.48 *Corrected value based onceftaroline fosamil acetate potency of 95.5%.

TABLE 14 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct 1.76 0.46 0.09 ND 0.11 ND ND 0.11 0.32 0.77

TABLE 15 Ceftaroline related substances (%) UNK UNK UNK UNK UNK UNK UNKUNK # 0.81 # 0.86 # 1.04 # 1.09 # 1.17 # 1.27 # 1.36 # 1.41 ND ND 0.13ND 0.06 ND ND ND

TABLE 16 NXL-104 related substances (%) Decarbonyl UNK # 0.30 UNK # 0.33UNK # 0.36 UNK # 0.37 0.21 0.21 0.27 0.09 0.12

Tables 17-20 show the assay and degradation profile of lyophilizedFormulation 3 stored at 40° C./75% RH for 2 weeks.

TABLE 17 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%)* U3 (w/oU3) (%) (%) (%) 4.82 87.4 5.6 3.85 103.4 0.44 *Corrected value based onceftaroline fosamil acetate potency of 95.5%.

TABLE 18 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct 1.53 0.45 0.08 ND 0.10 ND ND 0.11 0.31 0.84

TABLE 19 Ceftaroline related substances (%) UNK UNK UNK UNK UNK UNK UNKUNK # 0.81 # 0.86 # 1.04 # 1.09 # 1.17 # 1.27 # 1.36 # 1.41 ND ND 0.14ND 0.06 ND ND ND

TABLE 20 NXL-104 related substances (%) Decarbonyl UNK # 0.30 UNK # 0.33UNK # 0.36 UNK # 0.37 0.20 0.22 0.10 0.12 ND

Table 21-24 show the assay and degradation profile of lyophilizedFormulation 4 stored at 40° C./75% RH for 2 weeks.

TABLE 21 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamil TotalNXL-104 Assay impurities Total pH (%)* U3 (w/o U3) (%) Assay (%)impurities (%) 5.26 87.1 3.8 5.44 103.6 0.59 *Corrected value based onceftaroline fosamil acetate potency of 95.5%.

TABLE 22 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct 1.83 0.13 0.06 ND 0.13 ND ND 0.10 0.33 1.97

TABLE 23 Ceftaroline related substances (%) UNK UNK UNK UNK UNK UNK UNKUNK # 0.81 # 0.86 # 1.04 # 1.09 # 1.17 # 1.27 # 1.36 # 1.41 0.06 ND 0.360.09 0.09 ND ND ND

TABLE 24 NXL-104 related substances (%) Decarbonyl UNK # 0.30 UNK # 0.33UNK # 0.36 UNK # 0.37 0.18 0.16 0.11 0.14 ND

Formulation 5 was prepared with the following composition:

Ceftaroline fosamil=600 mg

NXL-104 (free acid)=600 mg

L-Arginine=434.3 mg

Citric acid monohydrate=1.08 mg

Trisodium citrate dihydrate=27.90 mg

Pluronic F127=18.00 mg (equivalent to approximately 5% w/w of finallyophile)

Tables 25-27 show the assay and degradation profile of lyophilizedFormulation 5 stored at 40° C./75% RH for 0 and 2 weeks.

TABLE 25 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%)* U3 (w/oU3) (%) (%) (%) t-zero 6.01 92.8 3.0 1.62 103.9 0.33 2 weeks 5.76 83.53.6 8.75 104.2 1.45 *Corrected value based on ceftaroline fosamilacetate potency of 95.5%.

TABLE 26 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct t-zero 0.45 0.05 0.08 ND 0.05 0.05 ND 0.12 <0.05 0.61 2 weeks3.90 0.12 0.18 <0.05 0.24 0.04 ND 0.11 0.38 3.05

TABLE 27 NXL-104 related substances (%) UNK UNK UNK UNK UNK Decarbonyl #0.36 # 0.47 # 0.55 # 0.95 # 0.97 t-zero 0.11 0.22 ND ND ND ND 2 weeks0.10 0.21 0.49 0.17 0.36 0.12

Formulation 6 was prepared with the following composition:

Ceftaroline fosamil=600 mg

NXL-104 (free acid)=600 mg

L-Arginine=434.3 mg

Hydroxy propyl β cyclodextrin (HPβCD)=1300 mg

Table 28-30 show the assay and degradation profile of lyophilizedFormulation 6 stored at 40° C./75% RH for 0 and 2 weeks.

TABLE 28 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%)* U3 (w/oU3) (%) (%) (%) t-zero 6.00 91.5 2.9 1.82 103.3 0.66 2 weeks 5.73 79.13.8 10.36 104.3 1.20 *Corrected value based on ceftaroline fosamilacetate potency of 95.5%.

TABLE 29 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct t-zero 0.41 <0.05 0.06 ND 0.05 0.06 ND 0.11 0.21 0.92 2 weeks3.19 0.08 0.34 0.07 0.22 0.07 ND 0.09 0.41 4.71

TABLE 30 NXL-104 related substances (%) UNK UNK UNK UNK UNK Decarbonyl #0.36 # 0.47 # 0.84 # 0.95 # 0.97 t-zero 0.05 0.21 ND 0.40 ND ND 2 weeks<0.05 0.18 0.32 ND 0.60 0.10

Formulation 7 was prepared with the following composition:

Ceftaroline fosamil=600 mg

NXL-104 (free acid)=600 mg

Citric acid monohydrate=10.8 mg

Trisodium citrate dihydrate=279.0 mg

Table 31 shows the assay for lyophilized Formulation 7 stored at 40°C./75% RH for 0 and 2 weeks.

TABLE 31 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 pH Assay (%)* U3 Assay (%) Total impurities (%) t-zero 4.58 96.63.9 105.4 2.51 2 weeks 4.58 87.3 7.6 104.4 2.85 *Corrected value basedon ceftaroline fosamil acetate potency of 95.5%.

Formulation 8 was prepared with the following composition:

Ceftaroline fosamil=450 mg

NXL-104 (free acid)=450 mg

L-Arginine=182.7 mg

Citric acid monohydrate=8.1 mg

Trisodium citrate dihydrate=209.3 mg

Table 32 shows the assay for lyophilized CXL Formulation 8 stored at 40°C./75% RH for 0 and 2 weeks.

TABLE 32 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 pH Assay (%)* U3 Assay (%) Total impurities (%) t-zero 5.40 94.73.2 106.1 2.29 2 weeks 5.38 87.7 5.0 105.0 2.34 *Corrected value basedon ceftaroline fosamil acetate potency of 95.5%.

Formulation 9 was prepared with the following composition:

Ceftaroline fosamil acetate=668.4 mg

NXL-104=649.8 mg

Citric acid monohydrate=87.8 mg

Trisodium citrate dihydrate=171.3 mg

(Citrate concentration=0.2M corresponding to pH 4.8)

Tables 33-35 show the assay and degradation profile of lyophilized CXLFormulation 9 stored at 40° C./75% RH for 0 and 1 month.

TABLE 33 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%)* U3 (w/oU3) (%) (%) (%) t-zero 3.54 95.5 3.8 0.92 103.6 1.18 1 month 3.62 82.410.39 3.96 101.9 2.06 *Corrected value based on ceftaroline fosamilacetate potency of 95.5%.

TABLE 34 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct t-zero 0.37 0.09 <0.05 <0.05 0.12 ND ND 0.06 0.28 ND 1 month 1.201.42 0.05 0.10 0.25 ND ND 0.08 0.45 ND

TABLE 35 NXL-104 related substances (%) Decarbonyl t-zero 0.94 1 month1.77

Formulation 10 was prepared with the following composition:

Ceftaroline fosamil acetate=668.4 mg

NXL-104=649.8 mg

Tartaric acid=150.0 mg (equivalent to 60 ml of 0.2M tartrate solution)

Sodium hydroxide=16.0 mg

L-Arginine=171.7 mg

Tables 36-38 show the assay and degradation profile of lyophilizedFormulation 10 stored at 40° C./75% RH for 0 and 1 month.

TABLE 36 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%)* U3 (w/oU3) (%) (%) (%) t-zero 3.42 94.9 3.7 1.10 104.2 1.05 1 month 3.49 85.28.80 3.67 102.6 2.28 *Corrected value based on ceftaroline fosamilacetate potency of 95.5%.

TABLE 37 Ceftaroline related substances (%) U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct t-zero 0.43 0.06 <0.05 <0.05 0.12 ND ND 0.06 0.30 0.13 1 month1.38 0.89 <0.05 0.07 0.24 0.01 ND 0.07 0.46 0.19

TABLE 38 NXL-104 related substances (%) Decarbonyl t-zero 0.81 1 month1.54

Example 8 Stability of Amorphous NXL-104 and Crystalline CeftarolineFosamil

A formulation containing amorphous NXL-104 and crystalline ceftarolinefosamil was prepared with the following composition per vial:

Ceftaroline fosamil 668.4 mg (monohydrate, acetic (equivalent to 600 mgof ceftaroline fosamil) acid solvate) L-Arginine 434.3 mg NXL-104 649.8mg (equivalent to 600 mg of NXL-104 free acid)

Amorphous NXL-104 was weighed into vials pre-filled with ceftarolinefosamil-Arginine blend. The vials were flushed with nitrogen, stoppered,sealed and stored at different conditions to monitor stability.Packaging components used were 20 ml Type 1 glass vial, Graychlorobutyl-isoprene stopper and Blue Aluminum tear-off seal.

Tables 39-41 show the stability data for the formulation at t-zero.

TABLE 39 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%) U3 (w/o U3)(%) (%) (%) Initial 5.49 100.45 2.74 0.92 101.21 0.72 3 hours 5.44 99.932.97 0.10 101.35 0.74 6 hours 5.46 99.74 3.19 0.98 101.30 0.75

TABLE 40 Decarbonyl and unknown impurities Decarbonyl UNK # 0.43 Initial0.56 0.16 3 hours 0.58 0.16 6 hours 0.59 0.16

TABLE 41 Ceftaroline related impurities UNK U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct # 1.55 Initial 0.47 0.04 ND ND 0.10 0.06 ND 0.08 0.04 0.13 0.00 3hours 0.53 0.05 ND ND 0.09 0.05 ND 0.08 0.04 0.12 0.04 6 hours 0.51 0.05ND ND 0.09 0.05 ND 0.07 0.04 0.12 0.05

Tables 42-44 show the stability data for the formulation stored for 3months at 40° C./75% RH.

TABLE 42 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%) U3 (w/o U3)(%) (%) (%) Initial 5.71 96.13 3.66 1.58 93.30 1.04 3 hours 5.62 95.383.87 1.55 92.98 1.16 6 hours 5.67 95.03 4.11 1.75 93.12 1.09

TABLE 43 Decarbonyl and unknown impurities UNK # UNK # Decarbonyl UNK #0.35 UNK # 0.38 0.39 0.53 Initial 0.73 0.03 0.05 0.03 0.21 3 hours 0.760.02 0.19 0.03 0.18 6 hours 0.77 0.03 0.19 0.03 0.15

TABLE 44 Ceftaroline related impurities UNK U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct # 1.56 Initial 0.50 0.13 ND ND 0.30 ND ND 0.08 0.22 0.27 0.08 3hours 0.56 0.14 ND ND 0.27 ND ND 0.08 0.23 0.27 ND 6 hours 0.62 0.14 NDND 0.24 0.05 ND 0.08 0.24 0.26 0.12

Tables 45-48 show the stability data for the formulation stored for 6months at 40° C./75% RH.

TABLE 45 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%) U3 (w/o U3)(%) (%) (%) Initial 5.69 96.80 3.83 1.77 90.34 1.49 3 hours 5.85 97.204.05 1.77 90.53 1.45 6 hours 5.77 95.80 4.31 1.74 90.40 1.43

TABLE 46 NXL-104 related impurities Decarbonyl UNK # 0.38 UNK # 0.55Initial 0.99 0.24 0.26 3 hours 0.98 0.24 0.23 6 hours 0.98 0.25 0.20

TABLE 47 Ceftaroline related impurities U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct Initial 0.38 0.10 <0.05 <0.05 0.34 0.06 ND 0.10 0.30 0.38 3 hours0.39 0.11 <0.05 <0.05 0.31 0.05 ND 0.09 0.30 0.37 6 hours 0.42 0.11<0.05 <0.05 0.29 0.05 ND 0.09 0.31 0.36

TABLE 48 Unknown impurities UNK UNK UNK UNK UNK UNK UNK # 0.18 # 0.24 #0.42 # 0.48 # 1.55 # 1.72 # 1.82 Initial <0.05 <0.05 <0.05 0.05 0.06<0.05 <0.05 3 hours 0.05 <0.05 <0.05 0.05 0.05 <0.05 <0.05 6 hours 0.05<0.05 <0.05 0.06 <0.05 <0.05 <0.05

Table 49-52 show the stability data for the formulation containingamorphous NXL-104 and crystalline ceftaroline fosamil stored for 9months at 40° C./75% RH.

TABLE 49 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%) U3 (w/o U3)(%) (%) (%) Initial 5.59 96.4 4.22 1.49 90.3 1.68 3 hours 5.61 97.0 4.281.47 90.0 1.66 6 hours 5.66 94.9 4.56 1.45 89.1 1.61

TABLE 50 Decarbonyl and unknown impurities Decarbonyl UNK # 0.38 UNK #0.40 UNK # 0.60 Initial 1.09 0.11 0.27 0.21 3 hours 1.08 0.11 0.27 0.206 hours 1.07 0.11 0.27 0.16

TABLE 51 Ceftaroline related impurities U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct Initial 0.33 0.11 <0.05 <0.05 0.22 0.04 ND 0.11 0.35 0.09 3 hours0.32 0.11 ND ND 0.21 0.04 ND 0.11 0.35 0.09 6 hours 0.33 0.11 <0.05<0.05 0.18 0.04 ND 0.10 0.36 0.09

TABLE 52 Unknown impurities UNK # UNK # UNK # UNK # 0.12 0.19 0.47 1.52Initial 0.12 ND 0.06 0.06 3 hours 0.12 ND 0.06 0.06 6 hours 0.13 0.050.06 <0.05

Table 53-56 show the stability data for the formulation containingamorphous NXL-104 and crystalline ceftaroline fosamil stored for 9months at 25° C./60% RH

TABLE 53 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%) U3 (w/o U3)(%) (%) (%) Initial 5.65 97.9 3.40 1.19 93.1 1.44 3 hours 5.57 97.1 3.471.11 92.5 1.40 6 hours 5.64 96.4 3.74 1.09 92.7 1.39

TABLE 54 Decarbonyl and unknown impurities Decarbonyl UNK # 0.38 UNK #0.40 UNK # 0.60 Initial 1.08 <0.05 0.25 0.11 3 hours 1.05 <0.05 0.250.10 6 hours 1.05 <0.05 0.25 0.09

TABLE 55 Ceftaroline related impurities U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct Initial 0.50 0.13 <0.05 <0.05 0.17 0.05 ND 0.14 0.11 0.09 3 hours0.43 0.13 <0.05 <0.05 0.16 0.04 ND 0.14 0.12 0.09 6 hours 0.44 0.14<0.05 <0.05 0.14 0.04 ND 0.13 0.12 0.08

TABLE 56 Unknown impurities UNK # UNK # UNK # UNK # 0.12 0.19 0.47 1.52Initial <0.05 <0.05 <0.05 <0.05 3 hours <0.05 <0.05 <0.05 <0.05 6 hours<0.05 <0.05 <0.05 <0.05

Table 57-60 show the stability data for the formulation containingamorphous NXL-104 and crystalline ceftaroline fosamil stored for 9months at 2-8° C.

TABLE 57 NXL-104 and ceftaroline fosamil assay Ceftaroline fosamilNXL-104 Total Total Assay impurities Assay impurities pH (%) U3 (w/o U3)(%) (%) (%) Initial 5.43 100.5 3.02 0.89 96.8 1.11 3 hours 5.50 100.63.07 0.87 97.0 1.11 6 hours 5.65 100.1 3.35 0.91 96.9 1.08

TABLE 58 Decarbonyl and unknown impurities Decarbonyl UNK # 0.38 UNK #0.40 UNK # 0.60 Initial 0.87 <0.05 0.24 ND 3 hours 0.84 <0.05 0.27 ND 6hours 0.84 <0.05 0.24 ND

TABLE 59 Ceftaroline related impurities U1 U2 U4 U5 U6 U7 U8 U9 MPTTAdduct Initial 0.45 0.11 <0.05 <0.05 0.09 0.05 ND 0.11 <0.05 0.08 3hours 0.43 0.11 <0.05 <0.05 0.09 0.05 ND 0.11 <0.05 0.08 6 hours 0.420.12 <0.05 <0.05 0.08 0.05 ND 0.11 0.05 0.08

TABLE 60 Unknown impurities UNK # UNK # UNK # UNK # 0.12 0.19 0.47 1.52Initial <0.05 <0.05 <0.05 <0.05 3 hours <0.05 ND ND ND 6 hours <0.05<0.05 <0.05 ND

Example 9 Stability of crystalline Form I oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and crystalline ceftaroline fosamil

A formulation containing Form I NXL-104 and crystalline ceftarolinefosamil was prepared with the following composition per vial:

Ceftaroline fosamil 668.4 mg (monohydrate, acetic acid (equivalent to600 mg of ceftaroline fosamil) solvate) L-Arginine 434.3 mg NXL-104649.8 mg (equivalent to 600 mg of NXL-104 free acid)

Ceftaroline fosamil,trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (Form I) and L-Arginine were blended in a twin shell blender(Patterson-Kelly) for times ranging from 15 to 60 minutes. The blend wassubsequently weighed into vials and the vials were stoppered (with orwithout nitrogen), sealed and stored at different conditions to monitorstability. Packaging components used were 20 ml Type I glass vial, Graychlorobutyl-isoprene stopper and Blue Aluminum tear-off seal.

Ceftaroline fosamil median particle diameter=10 μm

trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt (Form I) median particle diameter=145 μm

L-Arginine median particle diameter=Variable

Surprisingly and unexpectedly, the formulation comprising crystallineNXL-104 and ceftaroline fosamil was found to be more stable thanformulations comprising amorphous NXL-104 and ceftaroline fosamil.

Table 61-62 provide the stability data for the formulation comprisingForm I containing nitrogen in vial headspace. The median diameter ofL-Arginine was 290 μm.

TABLE 61 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Water Assay Decarbonyl Impurities Ceftaroline U3Impurities Content pH (%) (%) (%) Assay (%)* (%) (w/o U3) (%) (%) t-zero5.72 104.8 0.21 0.45 97.4 2.5 0.74 — 2 weeks 5.67 108.4 ND 0.33 100.72.6 0.70 — 2-8° C. 2 weeks 5.56 108.5 ND 0.38 99.9 2.8 0.90 — 25° C./60%RH 2 weeks 5.59 108.7 ND 0.45 97.5 3.4 1.01 — 40° C./75% RH 1 month 5.79106.4 <0.05 <0.05 97.4 2.6 0.64 — 2-8° C. 1 month 5.63 104.3 <0.05 0.2194.7 3.1 0.74 — 25° C./60% RH 1 month 5.71 104.6 <0.05 0.22 93.2 3.71.10 — 40° C./75% RH 3 months 5.76 104.7 0.02 0.02 95.9 3.31 1.14 1.1125° C./60% RH 3 months 5.87 104.6 0.02 0.02 94.6 3.97 1.52 1.10 40°C./75% RH

TABLE 62 Ceftaroline related substances (%) U1 U2 U6 U7 U9 MPTT Adductt-zero 0.32 ND 0.04 ND 0.10 0.23 ND 2 weeks 0.32 ND 0.06 0.01 0.05 0.190.07 2-8° C. 2 weeks 0.41 0.05 0.10 0.01 0.05 0.21 0.08 25° C./60% RH 2weeks 0.31 0.06 0.13 0.01 0.05 0.32 0.13 40° C./75% RH 1 month 0.24<0.05 0.09 0.01 0.05 0.20 0.05 2-8° C. 1 month 0.30 <0.05 0.17 ND <0.050.27 <0.05 25° C./60% RH 1 month 0.22 <0.05 0.20 ND 0.05 0.53 <0.05 40°C./75% RH 3 months 0.52 <0.05 0.19 <0.05 <0.05 0.37 0.06 25° C./60% RH 3months 0.38 <0.05 0.18 <0.05 <0.05 0.70 0.05 40° C./75% RH

Table 63-64 provide the stability data for the formulation comprisingForm I without nitrogen in vial headspace. The median diameter ofL-Arginine was 290 μm.

TABLE 63 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Ceftaroline Total Water Assay Decarbonyl Impuritiesfosamil U3 Impurities Content pH (%) (%) (%) Assay (%)* (%) (w/o U3) (%)(%) t-zero 5.76 104.8 0.21 0.45 98.0 2.50 0.71 — 3 months 5.81 104.70.03 0.03 94.4 4.04 1.67 0.98 40° C./75% RH 3 months 5.72 105.2 0.020.02 97.6 3.36 1.18 1.37 25° C./60% RH

TABLE 64 Ceftaroline related substances (%) U1 U2 U6 U7 U9 MPTT Adductt-zero 0.29 ND 0.04 ND 0.01 0.23 ND 3 months 0.41 <0.05 0.18 <0.05 <0.050.71 0.10 40° C./75% RH 3 months 0.53 <0.05 0.19 <0.05 0.05 0.36 0.1025° C./60% RH

Table 65-66 provide the stability data for the formulation comprisingForm I containing nitrogen in vial headspace. The median diameter ofL-Arginine was 20 μm.

TABLE 65 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Water Assay Decarbonyl Impurities Ceftaroline U3Impurities Content pH (%) (%) (%) Assay (%)* (%) (w/o U3) (%) (%) t-zero5.76 104.9 0.22 0.41 97.0 2.7 0.78 — 1 month 5.72 102.8 <0.05 0.26 97.33.0 0.43 — 2-8° C. 1 month 6.53 101.1 <0.05 0.25 93.0 3.3 0.43 — 25°C./60% RH 1 month 5.56 105.1 <0.05 1.19 94.5 4.1 0.82 — 40° C./75% RH 3months 5.81 107.3 ND ND 94.5 3.55 1.39 1.54 25° C./60% RH 3 months 6.79109.3 0.06 0.06 84.5 4.15 2.48 1.41 40° C./75% RH

TABLE 66 Ceftaroline related substances (%) U1 U2 U6 U7 U9 MPTT Adductt-zero 0.27 <0.05 0.10 ND 0.10 0.15 0.10 1 month 0.05 0.05 0.04 0.030.09 <0.05 0.10 2-8° C. 1 month 0.08 0.06 0.10 0.02 0.07 <0.05 0.05 25°C./60% RH 1 month 0.07 0.07 0.25 0.01 0.07 <0.05 0.05 40° C./75% RH 3months 0.64 <0.05 0.24 <0.05 <0.05 0.28 0.15 25° C./60% RH 3 months 0.51<0.05 0.39 0.05 <0.05 0.85 0.23 40° C./75% RH

Table 67-68 provide the stability data for the formulation comprisingForm I containing nitrogen in vial headspace. The median diameter ofL-Arginine was 290 μm.

TABLE 67 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Water Assay Decarbonyl Impurities Ceftaroline U3Impurities Content pH (%) (%) (%) Assay (%)* (%) (w/o U3) (%) (%) t-zero6.33 102.9 <0.05 <0.05 97.0 2.50 0.85 — 3 months 6.46 96.3 <0.05 <0.0595.9 3.24 0.97 1.45 25° C./60% RH 3 months 5.40 105.1 <0.05 <0.05 93.84.02 1.53 1.38 40° C./75% RH

TABLE 68 Ceftaroline related substances (%) U1 U2 U6 U7 U9 MPTT Adductt-zero 0.28 <0.05 0.08 0.03 0.05 0.24 0.17 3 months 0.29 <0.05 0.17 ND0.05 0.35 0.06 25° C./60% RH 3 months 0.20 <0.05 0.23 ND <0.05 0.84 0.0740° C./75% RH

Table 69-70 provide the stability data for the formulation comprisingForm I containing nitrogen in vial headspace. The median diameter ofL-Arginine was 181 μm.

TABLE 69 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Water Assay Decarbonyl Impurities Ceftaroline U3Impurities Content pH (%) (%) (%) Assay (%)* (%) (w/o U3) (%) (%) t-zero5.65 105.4 <0.05 0.25 98.8 2.44 0.71 1.62 1 month 5.85 105.7 <0.05 <0.0593.8 3.56 1.47 — 25° C./60% RH 1 month 5.65 107.9 <0.05 <0.05 97.0 3.021.18 — 40° C./75% RH

TABLE 70 Ceftaroline related substances (%) U1 U2 U6 U7 U9 MPTT Adductt-zero 0.27 <0.05 0.09 ND 0.06 0.29 <0.05 1 month 0.42 <0.05 0.18 0.020.05 0.64 0.10 25° C./60% RH 1 month 0.47 <0.05 0.13 0.02 0.05 0.42 0.0840° C./75% RH

Thus, the present example demonstrates that surprisingly andunexpectedly, formulations comprising Form I and ceftaroline fosamil aremore stable than formulations comprising amorphous NXL-104 andceftaroline fosamil.

Tables 71-72 provide the stability data for formulation comprising FormI that was irradiated by γ-radiation (45 KGy) containing nitrogen invial.

TABLE 71 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Assay Decarbonyl Impurities Ceftaroline U3Impurities (%) pH (%) (%) (%) Assay (%)* (%) w/o U3 t-zero 5.88 108.2<0.05 <0.05 99.3 2.44 0.84 After 5.55 101.1 <0.05 0.35 95.6 2.61 1.17irradiation *Adjusted by ceftaroline fosamil acetate potency

TABLE 72 Ceftaroline related substances (%) U1 U2 U4 U6 U7 U9 MPTTAdduct t-zero 0.26 ND <0.05 0.08 ND 0.05 0.33 0.12 After 0.28 0.05 <0.050.20 0.05 0.06 0.37 0.14 irradiation

Tables 73-74 provide the stability data for formulation comprising FormI that was irradiated by γ-radiation (45 KGy) without nitrogen in vial.

TABLE 73 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Assay Decarbonyl Impurities Ceftaroline U3Impurities (%) pH (%) (%) (%) Assay (%)* (%) w/o U3 t-zero 5.97 106.5<0.05 <0.05 97.6 2.41 0.77 After 5.47 100.6 <0.05 0.35 94.8 2.60 1.35irradiation *Adjusted by ceftaroline fosamil acetate potency

TABLE 74 Ceftaroline related substances (%) U1 U2 U4 U6 U7 U9 MPTTAdduct t-zero 0.25 ND <0.05 0.08 ND 0.05 0.33 0.06 After 0.24 0.05 <0.050.19 0.05 0.06 0.50 0.12 irradiation

Tables 75-76 provide the stability data for formulation comprising FormI that was irradiated by e-beam (45 KGy) containing nitrogen in vial.

TABLE 75 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Assay Decarbonyl Impurities Ceftaroline U3Impurities (%) pH (%) (%) (%) Assay (%)* (%) w/o U3 t-zero 5.88 108.2<0.05 <0.05 99.3 2.44 0.84 After 6.40 96.6 <0.05 0.32 94.3 2.45 1.12irradiation *Adjusted by ceftaroline fosamil acetate potency

TABLE 76 Ceftaroline related substances (%) U1 U2 U4 U6 U7 U9 MPTTAdduct t-zero 0.26 ND <0.05 0.08 ND 0.05 0.33 0.12 After 0.23 <0.05<0.05 0.20 0.06 0.06 0.42 0.13 irradiation

Tables 77-78 provide the stability data for formulation comprising FormI that was irradiated by e-beam (45 KGy) without nitrogen in vial.

TABLE 77 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Total Assay Decarbonyl Impurities Ceftaroline U3Impurities (%) pH (%) (%) (%) Assay (%)* (%) w/o U3 t-zero 5.97 106.5<0.05 <0.05 97.6 2.41 0.77 After 5.80 97.9 <0.05 0.31 94.9 2.50 1.17irradiation *Adjusted by ceftaroline fosamil acetate potency

TABLE 78 Ceftaroline related substances (%) U1 U2 U4 U6 U7 U9 MPTTAdduct t-zero 0.25 ND <0.05 0.08 ND 0.05 0.33 0.06 After 0.22 <0.05<0.05 0.19 0.06 0.06 0.39 0.23 irradiation

Example 10 Stability of Form II oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt and crystalline ceftaroline fosamil

Formulation comprising Form II of NXL-104 and ceftaroline fosamil wasprepared with the following composition per vial:

Ceftaroline fosamil (monohydrate, acetic acid solvate) 668.4 mg(equivalent to 600 mg of ceftaroline fosamil)

L-Arginine 434.3 mg

NXL-104 690.4 mg (equivalent to 600 mg of NXL-104 free acid)

Ceftaroline fosamil monohydrate, acetic acid solvate, NXL-104 (Form II)and L-Arginine were blended in a twin shell blender (Patterson-Kelly)for times ranging from 15 to 60 minutes. The blend was subsequentlyweighed into vials and the vials were stoppered (with or withoutnitrogen), sealed and stored at different conditions to monitorstability. Packaging components used were 20 ml Type I glass vial, Graybromobutyl Omni stopper and Blue Aluminum tear-off seal.

Tables 79-80 show the stability data for the formulation in a vialwithout nitrogen. The median diameter of L-Arginine was 20 μm.

TABLE 79 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Ceftaroline Total Assay Decarbonyl Impurities fosamil U3Impurities (%) pH (%) (%) (%) Assay (%)* (%) w/o U3 t-zero 4.80 113.80.10 0.10 102.2 2.89 1.15 3 months 5.90 99.9 0.17 0.33 91.2 4.32 1.9740° C./75% RH *Corrected by ceftaroline fosamil acetate potency

TABLE 80 Ceftaroline related substances (%) Total U1 U2 U6 U7 U9 MPTTAdduct unknown t-zero 0.39 <0.05 0.08 <0.05 0.06 0.41 0.17 <0.05 3months <0.05 <0.05 0.17 0.05 <0.05 1.14 0.05 0.30 40° C./75% RH

Tables 81-82 show the stability data for the formulation comprising FormII and ceftaroline fosamil in a vial containing nitrogen. The mediandiameter of L-Arginine was 20 μM.

TABLE 81 NXL-104 and ceftaroline fosamil assay NXL-104 CeftarolineNXL-104 Total Ceftaroline Total Assay Decarbonyl Impurities fosamil U3Impurities (%) pH (%) (%) (%) Assay (%)* (%) w/o U3 t-zero 6.77 102.30.08 0.08 92.3 2.30 1.49 3 months 5.80 98.3 0.25 0.49 87.2 4.17 2.11 40°C./75% RH *Corrected by ceftaroline fosamil acetate potency

TABLE 82 Ceftaroline related substances (%) Total U1 U2 U6 U7 U9 MPTTAdduct unknown t-zero 0.50 <0.05 0.08 0.11 0.05 0.47 0.24 <0.05 3 months0.09 <0.05 0.17 0.06 <0.05 1.25 <0.05 0.33 40° C./75% RH

Example 11 Pharmacokinetic Data

A single center, two-part randomized Phase I Study was conducted toevaluate the safety, tolerability, and pharmacokinetics of single andmultiple intravenous doses of ceftaroline fosamil and NXL-104 in healthymale and female subjects, aged 18 through 45 years.

Study Drugs

Ceftaroline fosamil for injection was supplied as a sterile powdercontaining a dry mixture of ceftaroline fosamil and L-arginine insingle-dose, clear vials containing 600 mg of ceftaroline fosamil (on acorrected basis, anhydrous acetate free).

NXL-104 for Injection(trans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamidesodium salt) was supplied as a sterile powder in single-dose, clearvials containing 600 mg of NXL-104 (on a free-acid basis).

Inclusion Criteria

To be eligible to participate in the study, subjects were required tomeet the following criteria:

-   -   1. Sign a written informed consent before any study procedures        were performed    -   2. Be healthy males or females, 18 through 45 years of age,        inclusive    -   3. If female, have a negative serum pregnancy test (β-human        chorionic gonadotropin [HCG]) at screening and a negative serum        or urine pregnancy test on Day −1    -   4. If female of child-bearing potential or female <2 years        postmenopausal, agree to and comply with using highly effective        double-barrier methods of birth control (eg, condom plus        diaphragm) while participating in this study    -   5. Have normal, or abnormal but not clinically significant,        results on the hematology evaluation, serum chemistry        evaluation, UA, vital sign evaluation, ECG, or physical        examination    -   6. Have negative test results for hepatitis B surface antigen,        anti-hepatitis B core antibody immunoglobulin M, anti-hepatitis        C virus antibody, rapid plasma reagin/VDRL values, and        anti-human immunodeficiency virus types 1    -   7. Be a nonsmoker (never smoked or have not smoked within the        previous 2 years)    -   8. Have a body mass index (BMI)≧18 kg/m² and ≦30 kg/m²    -   9. Have a supine pulse rate of not more than 100 bpm and not        less than 50 bpm during the vital sign assessment at screening

Exclusion Criteria

Subjects who met any of the following criteria were not eligible toparticipate in the study:

-   -   1. Any hypersensitivity or allergic reaction to any β-lactam        antibiotic or β-lactamase inhibitor    -   2. Clinically significant disease state in any body system that,        in the opinion of the examining physician, would place the        subject at risk or compromise the quality of the data    -   3. CrCl levels less than 80 mL/min (Cockcroft-Gault formula        estimate)    -   4. Supine systolic blood pressure (BP)≧140 mm Hg or ≦90 mm Hg at        screening    -   5. Supine diastolic BP≧90 mm Hg or ≦50 mm Hg at screening    -   6. Clinically significant ECG abnormalities based on PI        interpretation, such as a PR interval≧220 msec or ≦100 msec; QTc        interval≧450 msec for male and female subjects; sinus        bradycardia (<50 bpm); sick sinus syndrome; first-, second-, or        third-degree atrioventricular block; any type of tachycardia;        more than 1 PVC on a 12-lead ECG; incomplete or complete left        bundle-branch block; nonsinus rhythm; or evidence of myocardial        ischemia/infarction (either changes suggesting acute        ischemia/infarction or changes from previous tracings compatible        with the infarction during the preceding 6 months)    -   7. History of alcohol or substance abuse within the previous 5        years    -   8. Positive urine test results for any drug of abuse, including        cotinine or alcohol    -   9. Participation in any other clinical investigation using an        experimental drug requiring repeated blood draws within 30 days        of Day 1 of this study or participation in a blood donation        program within the preceding 60 days    -   10. Consumption of caffeine, cruciferous vegetables, or orange        or grapefruit-containing products within 48 hours before Day 1        or consumption of alcohol within 72 hours before Day 1    -   11. Any clinical condition that might affect the absorption,        distribution, biotransformation, or excretion of ceftaroline or        NXL-104    -   12. Employee or family member of an employee of the clinical        research organization at which the study was conducted    -   13. Any concomitant medications, including over-the-counter        medications and vitamin or herbal supplements (eg, St. Johns        wort), taken within 14 days or 5 half-lives (whichever is        longer) before Day 1 of study drug administration. (Hormonal        drug products are prohibited from 30 days before Day 1,        including oral contraceptives)    -   14. Previous use of ceftaroline or NXL-104 or previous        participation in an investigational study of ceftaroline or        NXL-104    -   15. Female subjects who were pregnant and/or breast-feeding    -   16. Inability or unwillingness to adhere to the study-specific        procedures and restrictions    -   17. Any hypersensitivity or allergic reaction to heparin    -   18. History of recent vaccination within 14 days of first dose        of study medication    -   19. History of a recent viral illness within 14 days of first        dose of study medication

Part A Part A was an open-label, 3-way crossover, single-dose study toevaluate the safety, tolerability, and pharmacokinetics of ceftarolineand NXL-104 following co-administration of a single intravenous (IV)dose of ceftaroline fosamil and NXL-104 in 12 healthy subjects.

The subjects were randomized (1:1:1) to receive three treatmentsequences A, B and C as shown in Table 83.

Treatment A: single dose of 600 mg ceftaroline fosamil via IV infusionover one hour.

Treatment B: single dose of 600 mg NXL-104 via IV infusion over onehour.

Treatment C: single dose of 600 mg ceftaroline fosamil and 600 mgNXL-104 via concomitant IV infusion over one hour.

TABLE 83 Part A - Treatment Sequence Treatment Sequence Period I PeriodII Period III (No. of Subjects) Treatment Treatment Treatment I A B C (4subjects) II C A B (4 subjects) III B C A (4 subjects)There was a 5-day washout period after the study drug administration.

Selection and Timing of Dose for Each Subject

Subjects in part A were randomized to receive study drug between 0800and 1000 hours following a standard breakfast given at 0700 hours onDays 1, 6, and 11. Following each dose administration, were to remainsemirecumbent (excluding time when study procedures require otherwise)and awake for 1 hours.

No concomitant medications were permitted during the study unless neededto treat an AE. Subjects were instructed not to take any drugs for atleast 14 days or 5 half-lives (whichever was longer) before the firstday of dosing and during the course of the study. Subjects were to bespecifically reminded that this includes over-the-counter medicationssuch as aspirin, acetaminophen, ibuprofen, vitamin preparations, herbaland dietary supplements, and cough syrup, as well as medicines requiringa prescription. No hormonal drug products (including oralcontraceptives) were to be allowed 30 days before Day 1 and throughoutthe study.

Screening

Part A (Day −21 to Day −2)

Screening was to be performed within 21 days before the first dose. Atscreening, a review of inclusion and exclusion criteria was conducted todetermine the subject's eligibility for enrollment. Study procedureswere reviewed with the subject, and documentation of informed consentwas obtained before any study procedures are performed.

The following procedures were performed and recorded at screening:

-   -   Collect blood samples for serology testing, hematology        evaluation (including CBC, prothrombin time and international        normalized ratio [PT/INR], partial thromboplastin time [PTT],        free hemoglobin, haptoglobin, and reticulocyte count), and        comprehensive metabolic panel    -   Collect urine for UA (including urine microscopy) and for        drugs-of-abuse screen    -   Perform β-HCG serum pregnancy test (female subjects only)    -   Calculate CrCl and BMI    -   Assess vital signs    -   Perform 12-lead ECG    -   Perform complete physical examination    -   Assess prior medications    -   Record medical and surgical history    -   Record any spontaneously reported AE or SAE between signing of        informed consent and Day −1 for subjects who comply with all        screening processes

Study Days

Subjects were admitted into a nonsmoking environment on Day −1 and wereto remain in the clinic until 48 hours following Day 11 doseadministration (Day 13), for a total of 13 overnight stays per subject(overnight stays Days −1 to 12).

The following protocol was used during the study days:

Day −1 (Period I)

-   -   Admit subjects to a nonsmoking environment    -   Collect any updated medical and surgical history not reported at        screening    -   Collect urine for UA (including urine microscopy)    -   Collect urine for drugs-of-abuse screen    -   Conduct serum or urine pregnancy test (female subjects only)    -   Perform a complete physical examination    -   Record weight    -   Calculate CrCl    -   Collect blood sample for Coombs test (direct and indirect        antiglobulin)        Collect blood samples for hematology evaluation (including CBC,        PT/INR, PTT, free hemoglobin, haptoglobin, and reticulocyte        count) and comprehensive metabolic panel    -   Assess AEs, SAEs, and prior medications    -   Provide dinner and snack at approximately 1800 and 2100 hours,        respectively

Day 1 (Period I)

-   -   Randomize each subject before the start of infusion    -   Administer study drug at 0800 hour via IV infusion over 1 hour        (±5 minutes) according to the treatment sequence assigned (per        Table 9.4.1-1)    -   Assess vital signs at 0.0 hour (within 4 hours before the start        of infusion) and 0.5, 1, 2, 4, and 8 hours (±15 minutes) after        the start of dose infusion    -   Collect PK blood samples at 0.0 hour (within 15 minutes before        the start of infusion) predose and after the start of infusion        at 20, 40, 60 (immediately before the end of study-drug        infusion), 65, and 75 minutes and 1.5, 2, 3, 4, 6, 8, 12, and 18        hours    -   Collect PK urine samples from −2 to 0 hours predose and over the        following continuous time intervals: 0 to 2, 2 to 4, 4 to 8, 8        to 12, and 12 to 24 hours after the start of infusion    -   Perform ECGs at 0.0 hour (within 20 minutes before the start of        infusion) predose and at 1, 2, and 4 hours (±20 minutes) after        the start of infusion    -   Assess AEs, SAEs, and concomitant medication use    -   Provide breakfast, lunch, dinner, and snack at approximately        0700, 1200, 1800, and 2100 hours, respectively

Day 2 (Period I), Day 7 (Period II), and Day 12 (Period III)

-   -   Assess vital signs at 24 hours (±15 minutes) after the start of        infusion in each period    -   Perform a 12-lead ECG 24 hours (±20 minutes) after the start of        study drug infusion in each period    -   Collect PK blood samples from 24 through 36 hours after the        start of study drug infusion in each period    -   Collect PK urine sample for 24-48 hours after the start of        infusion in each period    -   Assess AEs, SAEs, and concomitant medication use    -   Begin the washout period (applicable to period I and II only)    -   Provide breakfast, lunch, dinner, and snack at approximately        0700, 1200, 1800, and 2100 hours, respectively

Day 3 (Period I) and Day 8 (Period II)

-   -   Continue the washout period    -   Assess AEs, SAEs, and concomitant medication use    -   Complete the collection of PK urine sample from 24 to 48 hours        after the start of infusion in each period    -   Collect PK blood sample at 48 hours after the start of infusion        in each period    -   Provide breakfast, lunch, dinner, and snack at approximately        0700, 1200, 1800, and 2100 hours, respectively

Day 4 (Period I) and Day 9 (Period II)

-   -   Continue the washout period    -   Assess AEs, SAEs, and concomitant medication use    -   Provide breakfast, lunch, dinner, and snack at approximately        0700, 1200, 1800, and 2100 hours, respectively

Day 5 (Period II) and Day 10 (Period III)

-   -   Continue the washout period    -   Collect blood samples for hematology evaluation (including CBC,        PT/INR, PTT, free hemoglobin, haptoglobin, and reticulocyte        count) and comprehensive metabolic panel    -   Collect urine for UA (including urine microscopy)    -   Assess AEs, SAEs, and concomitant medication use    -   Provide breakfast, lunch, dinner, and snack at approximately        0700, 1200, 1800, and 2100 hours, respectively

Day 6 (Period II) and Day 11 (Period III)

-   -   Administer study drug at 0800 hour via IV infusion over 1 hour        (±5 minutes) according to the treatment sequence assigned (per        Table 9.4.1-1)    -   Assess vital signs at 0.0 hour (within 4 hours before the start        of infusion) and 0.5, 1, 2, 4, and 8 hours (±15 minutes) after        the start of dose infusion    -   Collect PK blood samples at 0.0 hour (within 15 minutes before        the start of infusion) predose and after the start of infusion        at 20, 40, 60 (immediately before the end of study-drug        infusion), 65, and 75 minutes and 1.5, 2, 3, 4, 6, 8, 12, and 18        hours    -   Collect PK urine samples at −2 to 0 hours predose and after the        start of infusion over the following continuous time intervals:        0 to 2, 2 to 4, 4 to 8, 8 to 12, and 12 to 24 hours    -   Perform ECGs at 0.0 hour (within 20 minutes before the start of        infusion) predose and at 1, 2, and 4 hours (±20 minutes) after        the start of infusion    -   Assess AEs, SAEs, and concomitant medication use    -   Provide breakfast, lunch, dinner, and snack at approximately        0700, 1200, 1800, and 2100 hours, respectively

Day 13 (Period III)

-   -   Assess AEs, SAEs, and concomitant medication use    -   Complete the collection of PK urine sample from 24 to 48 hours        after the start of infusion    -   Collect PK blood sample at 48 hours after the start of infusion    -   Provide breakfast at approximately 0700 hours    -   Perform a complete physical examination    -   Discharge subjects

End of Study (EOS)

EOS evaluations were completed within 7 to 10 days from Day 11 or at thetime of early discontinuation

Drug Concentration Measurements

Blood Sampling

Blood samples were collected at the following times to determineceftaroline, ceftaroline fosamil, ceftaroline M-1 (metabolite ofceftaroline fosamil), and NXL-104 free-acid plasma concentrations.

Days 1 (Period I), 6 (Period II), and 11 (Period III): in each studyperiod immediately before (within 15 minutes) the start of infusion andafter the start of study drug infusion at 20, 40, 60 (immediately beforethe end of study-drug infusion), 65, and 75 minutes and at 1.5, 2, 3, 4,6, 8, 12, 18, 24, 36, and 48 hours

Urine Sampling

Urine was collected during the following time intervals in each part ofstudy.

Part A

Urine was collected from −2 to 0 hours predose and from 0 to 2, 2 to 4,4 to 8, 8 to 12, 12 to 24, and 24 to 48 hours after the start ofinfusion in each period.

Pharmacokinetic Analyses

The principal parameters describing the pharmacokinetics of ceftaroline,ceftaroline fosamil, ceftaroline M-1 (metabolite of ceftarolinefosamil), and NXL-104 were derived from plasma concentrations usingnoncompartmental analysis with the software program WinNonlin. Plasmaconcentrations below the limit of quantification were treated as zerofor all PK calculations. The actual sampling times were used in thecalculations of PK parameters.

Plasma Data

The following PK parameters were determined for ceftaroline, ceftarolineceftaroline M-1, and NXL-104 free acid: AUC_(0-t) and area under theplasma concentration versus time curve from time zero to infinity(AUC_(0-∞)), C_(max), time of maximum plasma concentration (T_(max)),T_(1/2), CL, volume of distribution (V_(z)), and steady-state volume ofdistribution (V_(ss)). Minimum plasma concentration (C_(min)),accumulation ratio (R_(ac)), and area under the plasma concentrationversus time curve during the dosing interval, τ, (AUC_(0-τ)) will bedetermined following multiple-dose administration.

Because all doses of ceftaroline are expressed in terms of anhydrous,acetate-free ceftaroline fosamil (ceftaroline prodrug, molecularweight=684.68), the following corrections were made to the dose whencalculating PK parameters that include doses for ceftaroline (molecularweight=604.70) and ceftaroline M-1 (molecular weight=622.72):

Ceftaroline dose=0.883×ceftaroline fosamil dose

Ceftaroline M-1 dose=0.909×ceftaroline fosamil dose

The C_(max) of ceftaroline, ceftaroline fosamil, ceftaroline M-1, andNXL-104 free acid was determined observationally as the peakconcentration for each subject. T_(max) was determined as the timecorresponding to C_(max).

Area under the plasma concentration versus time curve up to the timecorresponding to the last measurable concentration (AUC_(0-t)) wascalculated by numeric integration using the linear trapezoidal rule asfollows:

${AUC}_{0 - t} = {\sum\limits_{i = 2}^{n}{0.5 \times \left( {C_{i} + C_{i - 1}} \right) \times \left( {t_{i} - t_{i - 1}} \right)}}$

in which C_(i) is the plasma ceftaroline, ceftaroline fosamil,ceftaroline M-1, and NXL-104 free-acid concentrations at thecorresponding sampling time point t_(i) and n is the number of timepoints up to and including the last quantifiable concentration.

Estimates of T_(1/2) were calculated using the following equation:T _(1/2)=0.693/λ_(z)in which λ_(z) is the terminal elimination rate constant and wasdetermined by noncompartmental analysis using WinNonlin. Brieflydescribed, a regression analysis was performed on the terminal linearphase of semilogarithmic plots of individual ceftaroline, ceftarolinefosamil, ceftaroline M-1, and NXL-104 free acid concentration-time data.

The AUC_(0-∞) was calculated according to the following equation:AUC_(0-∞)=AUC_(0-t +) C _(last)/λ_(z)

in which C_(last) is the last measurable concentration.

CL was calculated with the following equation:CL=Dose_(iv)/AUC_(0-∞)

V_(z) based on the terminal phase was determined as:V _(z=)Dose_(iv)/λ_(z)×AUC_(0-∞)C_(min) was determined observationally as the drug concentration at theend of the dosing interval at steady-state.

V_(ss) following multiple-dose administration was determined using thefollowing equations:

$V_{ss} = {{{CL} \times \frac{AUMC}{AUC}} - \frac{Tdur}{2}}$

in which with Tdur is the infusion duration

${AUMC}_{0 - \infty} = {{AUMC}_{0 - t} + \frac{C_{last}t_{last}}{\lambda_{z}} + \frac{C_{last}}{\lambda_{z}\lambda_{z}}}$

in which AUMC_(0-∞) is the area under the first moment of the plasmaconcentration-versus-time curve from time zero to infinity withextrapolation of the terminal phase.

Area under the first moment of the plasma concentration-versus-timecurve up to the time corresponding to the last measurable concentration(AUMC_(0-t)) was calculated by numeric integration using the lineartrapezoidal rule as follows:

${AUMC}_{0 - t} = {\sum\limits_{i = 2}^{n}{0.5 \times \left( {{C_{i}t_{i}} + {C_{i - 1}t_{i - 1}}} \right) \times \left( {t_{i} - t_{i - 1}} \right)}}$

R_(ac) was calculated using the following equation:

$R_{ac} = \frac{{AUC}_{0 - {t\mspace{14mu}{({{Day}\mspace{14mu} 7})}}}}{{AUC}_{0 - {t\mspace{14mu}{({{Day}\mspace{14mu} 1})}}}}$

Urine Data

The PK parameters to be determined from the urine excretion dataincluded the cumulative amount of ceftaroline, ceftaroline fosamil,ceftaroline M-1, and NXL-104 free acid excreted during the entire urinecollection period from time 0 to time t (Ae_(0-t)), renal clearance(CL_(r)) and the percent of dose excreted (% Dose). These parameterswere determined using noncompartmental analysis.

The cumulative amount of ceftaroline, ceftaroline fosamil, ceftarolineM-1, and NXL-104 excreted over all collection intervals, Ae_(0-t), wascalculated as

${A\; e_{0 - t}} = {\sum\limits_{i = 1}^{n}{Ae}_{i}}$

in which Ae_(i) is the amount of drug excreted per collection intervalcalculated asAe ₁=Concentration×Volume

CL_(r) of ceftaroline, ceftaroline fosamil, ceftaroline M-1, and NXL-104was determined according to the following equation:

${CL}_{r}^{-} = \frac{{Ae}_{0 - t}}{{AUC}_{0 - t}}$Percent dose excreted in urine was determined according to the followingequation:

Statistical Analyses of Pharmacokinetic Parameters

In part A, PK parameters were compared by analysis of variance using SASversion 9.1.3 on a UNIX operating system. A general linear model withsequence, subject within sequence, treatment, and period as factors wasused as the basis for the analysis. The PK parameters for ceftaroline,ceftaroline fosamil, and ceftaroline M-1 following administration ofceftaroline fosamil concomitantly with NXL-104 (test) were compared withthe PK parameters for these analytes following administration ofceftaroline fosamil alone (reference). In addition, the PK parametersfor NXL-104 following administration of NXL-104 concomitantly withceftaroline fosamil (test) were compared with the PK parameters forNXL-104 following administration of NXL-104 alone (reference).Statistical inference was based on log-transformed values for theC_(max) and AUC parameters. The 2-sided 90% CI for the ratio ofgeometric means of C_(max) and AUC between the test and referencetreatments was constructed. T_(max) for test and reference was comparedusing the Wilcoxon signed rank test.

There were no safety concerns and no pharmacokinetic interactions werefound between ceftaroline fosamil and NXL-104.

Table 84 provides the pharmacokinetic data for Part A of the study.

TABLE 84 Pharmacokinetic data for Part A C_(max) AUC_(0-inf) T_(1/2)Treatment (μg/mL) T_(max) (hr) (μg*hr/mL) (hr) Ceftaroline 600 mg Geomean 24.77 1.00 60.97 2.51 Ceftaroline CV (%) 27.55 (1.00-4.00)* 13.7013.88 fosamil 600 mg NXL-104 + Geo mean 26.71 1.00 60.02 2.47Ceftaroline CV (%) 12.06 (1.00-1.08)* 10.83 16.17 fosamil 600 mgCeftaroline 600 mg Geo mean 2.11 0.67 2.17 0.084 fosamil Ceftaroline CV(%) 30.73 (0.33-1.50)* 15.59 222.8 fosamil 600 mg NXL-104 + Geo mean2.37 0.67 2.16 0.055 Ceftaroline CV (%) 21.98 (0.33-1.00)* 11.97 12.34fosamil 600 mg Ceftaroline 600 mg Geo mean 3.29 1.08 16.42 3.75 M-1Ceftaroline CV (%) 43.02  (1.00-.6.00)* 18.72 11.26 fosamil 600 mgNXL-104 + Geo mean 3.21 1.04 15.78 3.78 Ceftaroline CV (%) 42.64(0.67-2.00)* 21.67 14.01 fosamil 600 mg NXL-104 600 mg NXL-104 Geo mean29.48 1.00 51.90 1.64 CV (%) 12.97 (1.00-1.08)* 11.60 26.32 600 mgNXL-104 + Geo mean 29.06 1.00 51.21 1.63 Ceftaroline CV (%) 11.65(1.00-1.08)* 13.52 19.97 fosamil 600 mg *Median (Min-Max)

Part B

Part B is a randomized, double-blind, placebo-controlled, 10-daymultiple dose study to evaluate the safety, tolerability, andpharmacokinetics of ceftaroline and NXL-104 following co-administrationof multiple IV doses of ceftaroline fosamil and NXL-104 over 10 days to48 healthy subjects. The treatment groups for Part B are as follows:

Treatment group I: multiple doses of 600 mg ceftaroline fosamil and 600mg NXL04 co-administered every 12 hours (q12h) via IV infusion over 1hour

Treatment group II: multiple doses of 400 mg ceftaroline fosamil and 400mg NXL-104 co-administered every 8 hours (q8h) via IV infusion over 1hour

Treatment group III: multiple doses of 900 mg ceftaroline fosamil and900 mg NXL-104 co-administered q12h via IV infusion over 1 hour

Treatment group IV: multiple doses of 600 mg ceftaroline fosamil and 600mg NXL-104 co-administered q8h via IV infusion over 1 hour

Treatment group V: multiple doses of placebo (normal saline)administered q12h via IV infusion over 1 hour

Treatment group VI: multiple doses of placebo (normal saline)administered q8h via IV infusion over 1 hour

Subject participation will require a commitment of up to 21 days, notincluding the Screening Visit, which may occur up to 21 days beforestudy drug administration. Treatment duration in each cohort for part Bis 10 days. Subjects will be confined to the clinical research unit fromDay −1 through Day 12.

The following PK parameters for ceftaroline, ceftaroline fosamil,ceftaroline M-1 (metabolite of ceftaroline fosamil), and NXL-104 freeacid will be calculated following multiple-dose administration: minimumplasma concentration (Cmin), accumulation ration (Rac), area under theplasma concentration versus time curve during the dosing interval, τ,(AUC0 τ), Cmax, Tmax, CL, T½, Ae0-t, CLr, and % Dose.

Table 85 gives the expected mean pharmacokinetic parameters for a singledose of 400 mg dose of ceftaroline fosamil, NXL-104 or a combination of400 mg ceftaroline fosamil and 400 mg NXL-104

TABLE 85 Expected pharmacokinetic parameters for a single 400 mg dose ofceftaroline fosamil, NXL-104 or 400 mg NXL-104 + ceftaroline fosamil 400mg C_(max) T_(max) AUC_(0-inf) T_(1/2) Treatment (μg/mL) (hr) (μg *hr/mL) (hr) Ceftaroline 400 mg Ceftaroline 16.51 0.67 40.65 1.67 fosamil400 mg NXL-104 + 17.81 0.67 40.01 1.65 Ceftaroline fosamil 400 mgCeftaroline 400 mg Ceftaroline 1.41 0.45 1.45 0.06 fosamil fosamil 400mg NXL-104 + 1.58 0.45 1.44 0.04 Ceftaroline fosamil 400 mg Ceftaroline400 mg Ceftaroline 2.19 0.72 10.95 2.5 M-1 fosamil 400 mg NXL-104 + 2.140.69 10.52 2.52 Ceftaroline fosamil 400 mg NXL-104 400 mg NXL-104 19.650.67 34.6 1.09 400 mg NXL-104 + 19.37 0.67 34.14 1.09 Ceftarolinefosamil 400 mg

Table 86 gives the expected mean pharmacokinetic parameters for a singledose of 900 mg dose of ceftaroline fosamil, NXL-104 or a combination of900 mg ceftaroline fosamil and 900 mg NXL-104

TABLE 86 Expected pharmacokinetic parameters for a single 900 mg dose ofceftaroline fosamil, NXL-104 or 900 mg NXL-104 + ceftaroline fosamil 900mg C_(max) T_(max) AUC_(0-inf) T_(1/2) Treatment (μg/mL) (hr) (μg *hr/mL) (hr) Ceftaroline 900 mg Ceftaroline 37.16 1.5 91.46 3.77 fosamil900 mg NXL-104 + 40.07 1.5 90.03 3.71 Ceftaroline fosamil 900 mgCeftaroline 900 mg Ceftaroline 3.17 1.01 3.26 0.13 fosamil fosamil 900mg NXL-104 + 3.56 1.01 3.24 0.08 Ceftaroline fosamil 900 mg Ceftaroline900 mg Ceftaroline 4.94 1.62 24.63 5.63 M-1 fosamil 900 mg NXL-104 +Ceftaroline fosamil 4.82 1.56 23.67 5.67 900 mg NXL-104 900 mg NXL-10444.22 1.5 77.85 2.46 900 mg NXL-104 + Ceftaroline fosamil 43.59 1.576.82 2.45 900 mg

The present invention is not to be limited in scope by the specificembodiments described herein. Indeed, various modifications of theinvention in addition to those described herein will become apparent tothose skilled in the art from the foregoing description and theaccompanying figures. Such modifications are intended to fall within thescope of the appended claims. It is further to be understood that allvalues are approximate, and are provided for description.

All patents, patent applications, publications, product descriptions,and protocols are cited throughout this application, the disclosures ofwhich are incorporated herein by reference in their entireties for allpurposes.

What is claimed is:
 1. A pharmaceutical composition comprising acrystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora pharmaceutically acceptable salt thereof and ceftaroline or a prodrugof ceftaroline, wherein the composition comprises less than about 0.6%of a compound of Formula (III):


2. The crystalline form according to claim 1, wherein the salt is asodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.3. The crystalline form according to claim 2, wherein the crystallineform has an X-Ray powder diffraction pattern comprising a characteristicpeak at about 13.0+/−0.5 degrees 2θ.
 4. The crystalline form accordingto claim 2, wherein the crystalline form has an X-Ray powder diffractionpattern comprising a characteristic peak at about 16.5+/−0.5 degrees 2θ.5. The crystalline form according to claim 2, wherein the crystallineform has an X-Ray powder diffraction pattern comprising a characteristicpeaks at about 17.5+/−0.5 degrees 2θ.
 6. The crystalline form accordingto any one of claims 3 to 5, wherein the crystalline form has an X-Raypowder diffraction pattern further comprising a characteristic peak atabout 17.3; about 22.3+/−0.5 degrees 2θ or a combination thereof.
 7. Thecrystalline form according to any one of claims 3 to 5, wherein thecrystalline form has an X-Ray powder diffraction pattern furthercomprising a characteristic peak at about 19.2; about 19.5+/−0.5 degrees2θ or a combination thereof.
 8. The crystalline form according to anyone of claims 3 to 5, wherein the crystalline form has an X-Ray powderdiffraction pattern further comprising a characteristic peak at about19.9; about 22.0; about 25.2; about 28.2+/−0.5 degrees 2θ or acombination thereof.
 9. The crystalline form according to any one ofclaims 3 to 5, wherein the crystalline form has an X-Ray powderdiffraction pattern further comprising a characteristic peak at about23.2; about 30.2; about 30.9; about 36.1+/−0.5 degrees 2θ or acombination thereof.
 10. The crystalline form according to claim 1,wherein the crystalline form has an X-Ray powder diffraction patterncomprising a characteristic peak at about 13.0; about 16.5; about 17.3;about 17.5; about 19.2; about 19.5; about 19.9; about 22.0; about 22.3;about 25.2; about 28.2+/−0.5 degrees 2θ or a combination thereof. 11.The crystalline form according to claim 1, wherein the crystalline formhas an X-Ray powder diffraction pattern comprising characteristic peaksat about 13.0; about 16.5; about 17.3; about 17.5; about 19.2; about19.5; about 19.9; about 22.0; about 22.3; about 23.2; about 25.2; about28.2; about 30.2; about 30.9 and about 36.1+/−0.5 degrees 2θ.
 12. Thecrystalline form according to claim 2, wherein the crystalline form hasan X-Ray powder diffraction pattern comprising a d-spacing value atabout 6.8+/−2 nm.
 13. The crystalline form according to claim 2, whereinthe crystalline form has an X-Ray powder diffraction pattern comprisinga d-spacing value at about 5.1+/−2 nm.
 14. The crystalline formaccording to claim 2, wherein the crystalline form has an X-Ray powderdiffraction pattern comprising a d-spacing value at about 5.4+/−2 nm.15. The crystalline form according any one of claims 12 to 14, whereinthe crystalline form has an X-Ray powder diffraction pattern furthercomprising a d-spacing value at about 3.2; about 3.5; about 4.0; about4.5; about 4.6+/−2 nm or a combination thereof.
 16. The crystalline formaccording to claim 1, wherein the crystalline form has an X-Ray powderdiffraction pattern comprising d-spacing values at about 2.5; about 2.9;about 3.0; about 3.2; about 3.5; about 3.8; about 4.0; about 4.5; about4.6; about 5.1; about 5.4; about 6.8+/−2 nm or a combination thereof.17. The crystalline form according to claim 1, wherein the crystallineform has an X-Ray powder diffraction pattern comprising d-spacing valuesat about 2.5; about 2.9; about 3.0; about 3.2; about 3.5; about 3.8;about 4.0; about 4.5; about 4.6; about 5.1; about 5.4; and about 6.8+/−2nm.
 18. A pharmaceutical composition comprising a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora pharmaceutically acceptable salt thereof.
 19. A pharmaceuticalcomposition comprising a crystalline form of a sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamideaccording to any one of claims 3 to
 5. 20. A composition comprisingabout 200 mg to about 1200 mg of a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora pharmaceutically acceptable salt thereof and ceftaroline or a prodrugof ceftaroline, wherein the composition provides an in vivo plasmaprofile for the crystalline form comprising a mean Cmax of less thanabout 100 ug/ml, and the composition comprises less than about 0.6% of acompound of Formula (III):


21. The composition according to claim 20 wherein the compositioncomprises the sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.22. The composition according to claim 20, wherein the compositioncomprises about 400 mg of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.23. The composition according to claim 20, wherein the compositioncomprises about 600 mg of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.24. The composition according to claim 20, wherein the compositioncomprises Form I of said crystalline form.
 25. The composition accordingto claim 20, wherein the in vivo plasma profile comprises a mean Cmax ofabout 10 to 50 ug/ml.
 26. The composition according to claim 20, furthercomprising about 200 mg to 1200 mg of ceftaroline or a prodrug ofceftaroline wherein the composition provides an in vivo plasma profilefor ceftaroline comprising a mean Cmax of less than about 100 ug/ml. 27.The composition according to claim 26, wherein the composition comprisesabout 400 mg ceftaroline fosamil.
 28. The composition according to claim26, wherein the composition comprises about 600 mg ceftaroline fosamil.29. The composition according to any one of claim 27 or 28, wherein thecomposition comprises ceftaroline fosamil monohydrate acetic acidsolvate.
 30. A composition comprising about 200 mg to 1200 mg of acrystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora pharmaceutically acceptable salt thereof and ceftaroline or a prodrugof ceftaroline, wherein the composition provides an in vivo plasmaprofile for the crystalline form comprising a mean AUC_(0-∞) of morethan about 10 ug h/ml, and the composition comprises less than about0.6% of a compound of Formula (III):


31. The composition according to claim 30, wherein the compositioncomprises the sodium salt of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.32. The composition according to claim 30, wherein the compositioncomprises about 400 mg of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.33. The composition according to claim 30, wherein the compositioncomprises about 600 mg of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.34. The composition according to claim 30, wherein the compositioncomprises Form I of said crystalline form.
 35. The composition accordingto claim 30, wherein the in vivo plasma profile comprises a meanAUC_(0-∞) of about 10 to 200 ug h/ml.
 36. The composition according toclaim 30, further comprising about 200 mg to 1200 mg of ceftaroline or aprodrug of ceftaroline wherein the composition provides an in vivoplasma profile for ceftaroline comprising a mean AUC_(0-∞) of more thanabout 10 ug h/ml.
 37. The composition according to claim 36, wherein thecomposition comprises about 400 mg ceftaroline fosamil.
 38. Thecomposition according to claim 36, wherein the composition comprisesabout 600 mg ceftaroline fosamil.
 39. The composition according to anyone of claim 37 or 38, wherein the composition comprises ceftarolinefosamil monohydrate acetic acid solvate.
 40. A composition comprisingabout 200 mg to 1200 mg of a crystalline form oftrans-7-oxo-6-(sulphooxy)-1,6-diazabicyclo[3,2,1]octane-2-carboxamide ora pharmaceutically acceptable salt thereof wherein the compositionprovides an in vivo plasma profile for the crystalline form comprising amean Tmax of more than about 10 minutes.
 41. The composition accordingto claim 40, wherein the composition comprises the sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.42. The composition according to claim 40, wherein the compositioncomprises about 400 mg of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.43. The composition according to claim 40, wherein the compositioncomprises about 600 mg of sodium salt of(1R,2S,5R)-7-oxo-6-sulphooxy-1,6-diazabicyclo[3.2.1]octane-2-carboxamide.44. The composition according to claim 40, wherein the compositioncomprises Form I of said crystalline form.
 45. The composition accordingto claim 40, wherein the in vivo plasma profile comprises a mean Tmax ofabout 30 minutes to about 2 hours.
 46. The composition according toclaim 40, further comprising about 200 mg to 1200 mg of ceftaroline or aprodrug of ceftaroline wherein the composition provides an in vivoplasma profile for ceftaroline comprising a mean Tmax of more than about10 minutes.
 47. The composition according to claim 36, wherein thecomposition comprises about 400 mg ceftaroline fosamil.
 48. Thecomposition according to claim 36, wherein the composition comprisesabout 600 mg ceftaroline fosamil.
 49. The composition according toanyone of claim 37 or 38, wherein the composition comprises ceftarolinefosamil monohydrate acetic acid solvate.
 50. The crystalline formaccording to claim 2, wherein the crystalline form is Form II.
 51. Thecrystalline form according to claim 2, wherein the crystalline form hasan X-Ray powder diffraction pattern comprising a characteristic peak atabout 17.1+/−0.5 degrees 2θ.
 52. The crystalline form according to claim2, wherein the crystalline form has an X-Ray powder diffraction patterncomprising a characteristic peak at about 16.4+/−0.5 degrees 2θ.
 53. Thecrystalline form according to claim 2, wherein the crystalline form hasan X-Ray powder diffraction pattern comprising a characteristic peak atabout 8.5+/−0.5 degrees 2θ.
 54. A composition comprising the crystallineform according to any one of claims 51 to 53.